Abstract Details

Title Recording Local Field Potentials During Bilateral DBS of the ALIC/VS-VC During Treatment of Obsessive Compulsive Disorder

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-009

Objective N/A

Background Obsessive–compulsive disorder (OCD) is a debilitating psychiatric illness characterized by time-consuming obsessions and/or compulsions that produce functional impairment. Neuroimaging data demonstrates a connection between OCD symptoms and aberrant activity within the cortico-striato-thalamo-cortical (CSTC) network. The anterior limb of the internal capsule/ventral capsule-ventral striatum (ALIC/VS-VC) represents an essential target for psychiatric neurosurgery due to its significance as a white matter convergence point connecting cortical networks to hippocampal, amygdaloid, thalamic, and brainstem structures. Evolving Medtronic BrainSense technology permits the continuous capture of local field potentials (LFPs) during the simultaneous delivery of DBS. Here we report a case study describing concurrent changes in OCD severity and LFPs of ALIC/VS-VC stimulation.

Design/Methods The subject is a 25-year-old male with a complex history of OCD and concurrent diagnoses of Tourette syndrome, anxiety, and depression. The patient underwent the bilateral implantation of Medtronic DBS leads in the ALIC/VS-VC paired with a Percept PC with BrainSense technology. LFP recording are performed during clinic visits as well as between appointments. During programming sessions, we attempted to evoke symptoms using an OCD provocation paradigm that presented photographic stimuli associated with the patient’s obsessions.

Results The patient’s YBOCS score improved by 22% 7 months following DBS activation. Baseline LFP recordings showed a consistent signal in the alpha range (at ~9Hz and ~12 Hz). Notably, when stimulation was adjusted to localize the alpha signal, this was associated with subsequent clinical improvement. Phasic changes in LFPs were not observed during OCD provocation, however, slight increases in alpha activity were observed after testing.

Conclusions Lateralized changes in alpha activity were observed during DBS activation and subsequent symptom attenuation. This case corroborates existing evidence implicating aberrant alpha activity in OCD and adds to the literature of potential biomarkers that can be used to guide parameter selection and track symptom responses in future OCD patients receiving DBS.

Authors/Disclosures
Yi-Han Lin, MD (University of Washington, Neurology) PRESENTER	The institution of Dr. Lin has received research support from UniQure. The institution of Dr. Lin has received research support from CHDI. The institution of Dr. Lin has received research support from Prilenia Therapeutics. The institution of Dr. Lin has received research support from Boston Scientific. The institution of Dr. Lin has received research support from BIAL.
Vicente Medrano Martinez (University of Washington)	No disclosure on file
Andrew Ko	No disclosure on file
Michael Schrift, DO	No disclosure on file

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