Deep brain stimulation (DBS) in patients with obsessive-compulsive disorder – a two-year follow-up on quality of life

Introduction Deep brain stimulation (DBS) is a neurosurgical procedure in which thin electrodes connected to a neuro-pacemaker are implanted into deep brain structures to modulate pathological neuronal activity with electrical current. DBS is used for symptom relief in Parkinson´s disease (Groiss et al. TAN Disord 2009; 2 79–91) and is under investigation for several psychiatric conditions (Naesström et al. NJP 2016; 70 483–91). Severe and treatment-resistant obsessive-compulsive disorder (OCD) may be treated with DBS to achieve reduced OCD symptoms, ultimately aiming for an improved quality of life. Objectives Our objective is to present preliminary data on OCD patients’ self-reported quality of life related to the development of OCD symptoms, before DBS surgery, and up to two years after surgery. Methods Patients with severe OCD (n=12) were enrolled in an open-label clinical trial on DBS delivered into the brain area of the bed nucleus of stria terminalis (BNST), as previously described (Naesström et al. W Neurosurg 2021; 149 e794-e802). The patients completed the EuroQOL five dimensions questionnaire (EQ-5D-3L) and were assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS) before DBS surgery and after six, 12, and 24 months. The paired t-test was used to analyze for group differences. Results The mean age at DBS surgery was 39.2 years (standard deviation [SD] 15.5) and the baseline YBOCS score corresponded to severe to extreme OCD (mean 33, SD 3.0). The mean EQ-5D index score was 0.62 (SD 0.11) at baseline and had improved to 0.74 (SD 0.13) at the two-year follow-up and the difference was statistically significant ( t = 2.8, df = 7, p-value = 0.025). The EQ-5D VAS scores measured pre-surgery were low (mean 35.9, SD 22.2) and had increased two years post-surgery (mean 54.4, SD 21.0), but with no statistically significant difference ( t = 1.9, df = 8, p-value = 0.093). Conclusions Quality of life in OCD patients two years after DBS surgery measured with the EQ-5D-3L showed an improvement two years following surgery for the EQ-5D index but not for the VAS scale. These preliminary data show that self-assessment with the EQ-5D-3L scale may be used to follow up on patients’ quality of life after DBS and longer follow-up periods are warranted. Disclosure of Interest None Declared