• Stéphan Chabardès, Mircea Polosan, Paul Krack, Julien Bastin, Alexandre Krainik, Olivier David, Thierry Bougerol, and Alim Louis Benabid.
• Université Joseph Fourier, Grenoble, France; Clinique de Neurochirurgie, Centre Hospitalier Universitaire, Grenoble, France; INSERM U836, Grenoble Institut des Neurosciences, Grenoble, France. Electronic address: SChabardes@chu-grenoble.fr.
• World Neurosurg. 2013 Sep 1;80(3-4):S31.e1-8.

AbstractBecause of its reversibility and adaptability, deep brain stimulation (DBS) has recently gained interest in psychiatric disorders, such as obsessive-compulsive disorders (OCD) and depression. In OCD, DBS is now an alternative procedure to lesions of fascicles such as the anterior capsule, which links the orbitofrontal cortex, the cingulum, and the thalamus, and has been applied to new target such as the nucleus accumbens, with promising results. However, a recent interest has been developed toward the subthalamic nucleus (STN), a key structure of the basal ganglia that connects the motor, limbic, and associative systems. It is known from patients with Parkinson disease that STN-DBS can have significant effects on mood and cognition. Those transient effects are usually seen as "side effects" in Parkinson disease, but are clues to the underappreciated role that STN plays in the limbic circuitry, a role whose precise details are as yet unknown and under active investigation. We present the rationale supporting the use of nonmotor STN as a therapeutic target to treat OCD. In particular, we discuss the recent experience and preliminary results of our group after 6 months of nonmotor STN-DBS in patients with severe OCD.Copyright © 2013 Elsevier Inc. All rights reserved.

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