Brain ‘Pacemakers’ could help patients with OCD: Parkinson’s-style zapping treatment suppresses mental health symptoms, review says
- A similar brain-zapping treatment has been used in Parkinson’s patients for decades
- Despite Showing Promise in OCD Treatment, Actual Evidence Is Thin
- Scientists pooling all available studies said the results were ‘encouraging’
Brain ‘pacemakers’ could help thousands of people with obsessive compulsive disorder (OCD), researchers said today.
Delivering sharp, electrical currents deep into the brain can suppress the symptoms of the distressing mental state.
A similar brain-zapping treatment has been given to Parkinson’s patients for decades, proven to thwart their tremors and help them walk free.
Despite showing signs of promise in treating OCD, the actual evidence surrounding deep brain stimulation (DBS) is thin.
Delivering sharp, electrical currents deep into the brain can suppress the symptoms of the distressing mental state. A similar brain-zapping treatment has been given to Parkinson’s patients for decades
Around 750,000 Britons are thought to be living with the condition, which can cause patients to become obsessed with washing their hands, cleaning up and checking doors are locked.
Charities estimate that up to 3 million Americans are affected, including Hollywood stars Justin Timberlake and Jessica Alba.
About half of patients have ‘severe’ symptoms, which can have such an impact on patients that they don’t want to leave their home.
Treatment usually includes cognitive behavioral therapy, which helps patients face their obsessive thoughts without “correcting” them.
What is Obsessive Compulsive Disorder?
Obsessive-compulsive disorder, commonly known as OCD, is a common mental illness that causes people to become obsessed with thoughts and develop behaviors that are difficult to control.
It can affect anyone at any age, but normally develops during young adulthood.
It can cause people to have repetitive unwanted or unpleasant thoughts.
People can also develop compulsive behaviors – a physical act or something mental – which they do over and over to try to relieve the obsessive thoughts.
The condition can be controlled and treatment usually includes psychological therapy or medication.
It is not known why OCD occurs, but risk factors include a family history of the condition, certain differences in brain chemicals, or major life events such as childbirth or death.
People who are naturally neat, methodical, or anxious are also more likely to develop it.
Drugs are also being handed out, with antidepressants used to alter the chemical balance in the brain. While doctors are baffled as to what causes OCD, they believe unusually low or high levels of serotonin may be to blame.
DBS is already approved in the US for OCD, but only in the most severe, treatment-resistant cases.
Surgeons target certain areas of the brain with the electrical impulses, ignoring any abnormal brain cell firing patterns — and replicating how it works in Parkinson’s.
But NHS chiefs argue that the procedure – which involves surgically implanting a pulse generator similar to a pacemaker in the chest, which is connected by wires to specific areas of the brain – should only be used for research purposes because of the ‘inadequate’ evidence proving it is safe or effective.
Researchers at the Baylor College of Medicine in Houston have reviewed all of the available literature on using the risky surgery to treat OCD.
It involved pooling the results of more than 30 studies on the subject, involving 350 adults with severe to extreme cases of the condition.
None of the patients, who lived an average of two decades with the condition, had seen any improvement in their symptoms over time.
But volunteers who received DBS had only half the number of symptoms after surgery than before, the analysis found.
Two-thirds of the participants also said the effects were life-changing.
The team called their results, disclosed in the Journal of Neurology, “encouraging” and said there was “strong evidence” to support DBS for OCD.
Still, Dr Sameer Sheth and colleagues also admitted that the procedure is “not without limitations.”
The team said, “First and foremost, it requires chronic hardware implantation and carries the associated risk of complications.”
Surgery to insert electrodes into the brain usually takes six hours.
A follow-up surgery to implant the breast stimulator is performed about a week later.
As with any surgery, the risks include bleeding, infection, and blood clots. Placement of the DBS can also cause seizures in rare cases.
A few patients in the analysis also developed “obsessions” with the stimulation itself, which can cause a tingling sensation.
Writing in the magazine, Dr. Sheth and team: ‘It remains a major barrier to the effective implementation of DBS for OCD in certain patients.’