Decrease of prefrontal metabolism after subthalamic stimulation in obsessive-compulsive disorder: a positron emission tomography study.
Biological Psychiatry. 2010-12-01; 68(11): 1016-1022
DOI: 10.1016/j.biopsych.2010.06.033
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1. Biol Psychiatry. 2010 Dec 1;68(11):1016-22. doi:
10.1016/j.biopsych.2010.06.033. Epub 2010 Oct 16.
Decrease of prefrontal metabolism after subthalamic stimulation in
obsessive-compulsive disorder: a positron emission tomography study.
Le Jeune F(1), Vérin M, N’Diaye K, Drapier D, Leray E, Du Montcel ST, Baup N,
Pelissolo A, Polosan M, Mallet L, Yelnik J, Devaux B, Fontaine D, Chereau I,
Bourguignon A, Peron J, Sauleau P, Raoul S, Garin E, Krebs MO, Jaafari N, Millet
B; French Stimulation dans le trouble obsessionnel compulsif (STOC) study group.
Collaborators: Mallet L, Agid Y, Aouizerate B, Arbus C, Bougerol T, Damier P,
Fontaine D, Houeto JL, Krebs MO, Lemaire JJ, Mallet L, Millet B, Pollak P,
Hourton D, Aprelon S, Jourdain C, Bardinet E, Yelnik J, Burbaud P, Welter ML,
Clair AH, Czernecki V, Vérin M, Tézenas du Montcel S, Madar D, Mallet L,
Pelissolo A, Tezenas du Montcel S, Welter ML, Yelnik J, Mallet L, Pelissolo A,
Agid Y, Cornu P, Navarro S, Welter ML, Hartmann A, Pidoux B, Grabli D, Czernecki
V, Dormont D, Galanaud D, Yelnik J, Bardinet E, Béhar C, Worbe Y, Clair AH,
Moutaud B, Aouizerate B, Burbaud P, Cuny E, Guehl D, Llorca PM, Chéreau I,
Lemaire JJ, Durif F, Derost P, Coste J, Gabrillargues J, Barget M, de Chazeron
I, Bougerol T, Polosan M, Benabid AL, Chabardès S, Seigneuret E, Krack P, Pollak
P, Ardouin C, Le Bas JF, Damier P, Lajat Y, Raoul S, Mattei V, Fontaine D, Borg
M, Paquis P, Michel E, Robert P, Magnié-Mauro MN, Papetti F, Baup N, Devaux B,
Krebs MO, Oppenheimer C, Olié JP, Ranoux D, Chayet M, Houeto JL, Jaafari N,
Bataille B, Mesnage V, Gil R, Audouin V, Senon JL, Millet B, Vérin M, Drapier D,
Sauleau P, Drapier S, Arbus C, Lazorthe Y, Chaynes P, Fabre N, Simonetta M,
Schmitt L, Lotterie JA, Camassel C, Aussilloux JC, Blond S, Feingold J, Sicard
D, Adès J, Cottraux J, Goudemand M.
Author information:
(1)Department of Nuclear Medicine, Centre Eugène Marquis, Rennes, France.
BACKGROUND: High-frequency bilateral subthalamic nucleus (STN) deep brain
stimulation (DBS) is a promising treatment in refractory obsessive-compulsive
disorder (OCD).
METHOD: Using the crossover, randomized, and double-blind procedure adopted by
the STOC study, 10 patients treated with high-frequency bilateral STN DBS
underwent am 18-fluorodeoxyglucose positron emission tomography (PET)
investigation to highlight the neural substratum of this therapeutic approach.
RESULTS: The median Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores for
all 10 patients were 31 (minimum = 18, maximum = 36) with « Off-Stimulation »
status and 19 (minimum = 0, maximum = 30) with « On-Stimulation » status (p =
.05). The OCD patients in Off-Stimulation status showed a hypermetabolism in the
right frontal middle and superior gyri, right parietal lobe, postcentral gyrus,
and bilateral putamen compared with healthy control subjects. A significant
decrease in cerebral metabolism was observed in the left cingulate gyrus and the
left frontal medial gyrus in On-Stimulation conditions compared with
Off-Stimulation conditions. In addition, the improvement assessed by Y-BOCS
scores during the On-Stimulation conditions was positively correlated with PET
signal changes at the boundary of the orbitofrontal cortex and the medial
prefrontal cortex, between PET signal changes and the Y-BOCS scores
modifications in On-Stimulation status.
CONCLUSION: This study suggests that the therapeutic effect of STN DBS is
related to a decrease in prefrontal cortex metabolism.
Copyright © 2010 Society of Biological Psychiatry. Published by Elsevier Inc.
All rights reserved.
DOI: 10.1016/j.biopsych.2010.06.033
PMID: 20951978 [Indexed for MEDLINE]