Effect of subthalamic nucleus stimulation on obsessive—compulsive disorder in a patient with Parkinson disease

Case report

Denys Fontaine Departments of Neurosurgery, Psychiatry, Neurology, CNS Functional Exploration, and Memory Center, Centre Hospitalier Universitaire de Nice, France

Search for other papers by Denys Fontaine in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Vianney Mattei Departments of Neurosurgery, Psychiatry, Neurology, CNS Functional Exploration, and Memory Center, Centre Hospitalier Universitaire de Nice, France

Search for other papers by Vianney Mattei in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Michel Borg Departments of Neurosurgery, Psychiatry, Neurology, CNS Functional Exploration, and Memory Center, Centre Hospitalier Universitaire de Nice, France

Search for other papers by Michel Borg in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Daniel von Langsdorff Departments of Neurosurgery, Psychiatry, Neurology, CNS Functional Exploration, and Memory Center, Centre Hospitalier Universitaire de Nice, France

Search for other papers by Daniel von Langsdorff in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Marie-Noelle Magnie Departments of Neurosurgery, Psychiatry, Neurology, CNS Functional Exploration, and Memory Center, Centre Hospitalier Universitaire de Nice, France

Search for other papers by Marie-Noelle Magnie in
Current site
Google Scholar
PubMed
Close
 M.D., Ph.D.
,
Stéphane Chanalet Departments of Neurosurgery, Psychiatry, Neurology, CNS Functional Exploration, and Memory Center, Centre Hospitalier Universitaire de Nice, France

Search for other papers by Stéphane Chanalet in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Philippe Robert Departments of Neurosurgery, Psychiatry, Neurology, CNS Functional Exploration, and Memory Center, Centre Hospitalier Universitaire de Nice, France

Search for other papers by Philippe Robert in
Current site
Google Scholar
PubMed
Close
 M.D.
, and
Philippe Paquis Departments of Neurosurgery, Psychiatry, Neurology, CNS Functional Exploration, and Memory Center, Centre Hospitalier Universitaire de Nice, France

Search for other papers by Philippe Paquis in
Current site
Google Scholar
PubMed
Close
 M.D.
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $525.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $624.00
USD  $45.00
USD  $525.00
USD  $624.00
Print or Print + Online Sign in

✓ The authors report on a patient with Parkinson disease (PD) and severe obsessive—compulsive disorder (OCD), in whom bilateral stimulation of the subthalamic nucleus (STN) was used to treat both PD and OCD symptoms.

This 49-year-old man had displayed symptoms of PD for 13 years. Progressively, his motor disability became severe despite optimal medical treatment. In parallel, he suffered severe OCD for 16 years, with obsessions of accumulation and compulsions of gathering and rubbing that lasted more than 8 hours per day. Bilateral high-frequency STN stimulation was performed to treat motor disability. After surgery (at 1-year follow up), motor and OCD symptoms were dramatically improved. The pre- and postoperative Yale—Brown Obsessive—Compulsive Scale scores were 32 and 1, respectively. No additional antiparkinsonian drugs were administered.

This case and other recent reports indicate that OCD symptoms can be improved by deep brain stimulation, a finding that opens new perspectives in the surgical treatment of severe and medically intractable OCD.

  • Collapse
  • Expand
  • 1.

    Akiskal HS: Dysthymia and cyclothymia in psychiatric practice a century after Kraepelin. J Affect Disord 62:1731, 2001 Akiskal HS: Dysthymia and cyclothymia in psychiatric practice a century after Kraepelin. J Affect Disord 62:17–31, 2001

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Alegret M, , Junqué C, & Valldeoriola F, et al: Effect of bilateral subthalamic stimulation on cognitive function in Parkinson disease. Arch Neurol 58:12231227, 2001 Alegret M, Junqué C, Valldeoriola F, et al: Effect of bilateral subthalamic stimulation on cognitive function in Parkinson disease. Arch Neurol 58:1223–1227, 2001

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Alegret M, , Junqué C, & Valldeoriola F, et al: Obsessive-compulsive symptoms in Parkinson's disease. J Neurol Neurosurg Psychiatry 70:394396, 2001 Alegret M, Junqué C, Valldeoriola F, et al: Obsessive-compulsive symptoms in Parkinson's disease. J Neurol Neurosurg Psychiatry 70:394–396, 2001

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Alexander GE, , DeLong MR, & Strick PL: Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci 9:357381, 1986 Alexander GE, DeLong MR, Strick PL: Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci 9:357–381, 1986

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Benabid AL, , Benazzouz A, & Hoffmann D, et al: Long-term electrical inhibition of deep brain targets in movement disorders. Mov Disord 13 (Suppl 3):119125, 1998 Benabid AL, Benazzouz A, Hoffmann D, et al: Long-term electrical inhibition of deep brain targets in movement disorders. Mov Disord 13 (Suppl 3):119–125, 1998

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Cummings JL: Frontal-subcortical circuits and human behavior. Arch Neurol 50:873880, 1993 Cummings JL: Frontal-subcortical circuits and human behavior. Arch Neurol 50:873–880, 1993

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Dostrovsky JO, & Lozano AM: Mechanisms of deep brain stimulation. Mov Disord 17 (Suppl 3):S63S68, 2002 Dostrovsky JO, Lozano AM: Mechanisms of deep brain stimulation. Mov Disord 17 (Suppl 3):S63–S68, 2002

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Fahn S, & Elton RL, Members of the Unified Development Committee: Unified Parkinson's Disease Rating Scale (UPDRS), in Fahn S, , Marsden CD, & Calne CD, et al (eds): Recent Development in Parkinson's Disease. Florhan Park, NJ: Macmillan, 1987, Vol 2, pp 153163 Fahn S, Elton RL, Members of the Unified Development Committee: Unified Parkinson's Disease Rating Scale (UPDRS), in Fahn S, Marsden CD, Calne CD, et al (eds): Recent Development in Parkinson's Disease. Florhan Park, NJ: Macmillan, 1987, Vol 2, pp 153–163

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Goodman WK, , Price LH, & Rasmussen SA, et al: The Yale-Brown obsessive compulsive scale. Part I. Development, use and reliability. Arch Gen Psychiatry 46:10061011, 1989 Goodman WK, Price LH, Rasmussen SA, et al: The Yale-Brown obsessive compulsive scale. Part I. Development, use and reliability. Arch Gen Psychiatry 46:1006–1011, 1989

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Houeto JL, , Mesnage V, & Mallet L, et al: Behavioural disorders, Parkinson's disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry 72:701707, 2002 Houeto JL, Mesnage V, Mallet L, et al: Behavioural disorders, Parkinson's disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry 72:701–707, 2002

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Mallet L, , Mesnage V, & Houeto JL, et al: Compulsions, Parkinson's disease, and stimulation. Lancet 360:13021304, 2002 Mallet L, Mesnage V, Houeto JL, et al: Compulsions, Parkinson's disease, and stimulation. Lancet 360:1302–1304, 2002

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Mattis S: Dementia Rating Scale. Odessa, FL: Psychological Assessment Resources, 1988 Mattis S: Dementia Rating Scale. Odessa, FL: Psychological Assessment Resources, 1988

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Montgomery SA, & Asberg M: A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382389, 1979 Montgomery SA, Asberg M: A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389, 1979

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Nuttin BJ, , Gabriels LA, & Cosyns PR, et al: Long-term electrical capsular stimulation in patients with obsessive-compulsive disorder. Neurosurgery 52:12631274, 2003 Nuttin BJ, Gabriels LA, Cosyns PR, et al: Long-term electrical capsular stimulation in patients with obsessive-compulsive disorder. Neurosurgery 52:1263–1274, 2003

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Pillon B, , Ardouin C, & Damier P, et al: Neuropsychological changes between “off” and “on” STN or Gpi stimulation in Parkinson's disease. Neurology 55:411418, 2000 Pillon B, Ardouin C, Damier P, et al: Neuropsychological changes between “off” and “on” STN or Gpi stimulation in Parkinson's disease. Neurology 55:411–418, 2000

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Reitan RM, & Davison LA: Clinical Neuropsychology: Current Status and Applications. New York: John Wiley & Sons, 1974 Reitan RM, Davison LA: Clinical Neuropsychology: Current Status and Applications. New York: John Wiley & Sons, 1974

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Saxena S, , Brody AL, & Schwartz JM, et al: Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder. Br J Psychiatry 173 (Suppl 35):2637, 1998 Saxena S, Brody AL, Schwartz JM, et al: Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder. Br J Psychiatry 173 (Suppl 35):26–37, 1998

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Saxena S, & Rauch SL: Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin North Am 23:563586, 2000 Saxena S, Rauch SL: Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin North Am 23:563–586, 2000

    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1655 391 27
Full Text Views 218 19 6
PDF Downloads 197 13 2
EPUB Downloads 0 0 0