Long-term outcomes of nucleus accumbens/anterior limb of the internal capsule deep brain stimulation in treatment-resistant obsessive-compulsive disorder
6 affiliations
- 1Department of Stereotactic and Functional Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital Cologne
- 2Graduate Studies and Research Section, Escuela Superior de Medicina, Instituto Politécnico Nacional
- 3Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne
- 4Department of Psychiatry and Psychotherapy III, LVR Hospital Bonn
- 5Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg
- 6Alexianer Hospital Cologne, Alexianer Köln GmbH
Abstract
Background: Deep brain stimulation (DBS) is a therapeutic option for carefully selected patients with severe, treatment-resistant obsessive-compulsive disorder (OCD), but very long-term outcomes remain insufficiently characterized. We evaluated clinical outcomes after DBS targeting the nucleus accumbens/anterior limb of the internal capsule (NAcc/ALIC) over 3–21 years and described the trajectories of early responders, delayed responders, and non-responders.
Methods: This single-center retrospective cohort included 30 consecutive patients (17 women) who underwent NAcc/ALIC DBS between 2004 and 2022. Outcomes were assessed with the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) at baseline (T0), 1 year after surgery (T1), and the latest follow-up at ≥3 years (T2). Response was defined as a ≥35% reduction from baseline. Repeated-measures ANOVA with Bonferroni-adjusted pairwise comparisons was used to assess changes over time.
Results: Y-BOCS scores decreased significantly across T0, T1, and T2. At T2, 22 of 30 patients (73.3%) met the response criterion; eight were delayed responders. Of the 15 patients who met the response criterion at T1, 14 retained it at T2 and 1 did not.
Conclusion: Clinically meaningful improvement was sustained at long-term follow-up, and some patients who had not responded after 1 year met the response criterion later. Once response was achieved, subsequent loss of response appeared uncommon in this cohort. The retrospective design and heterogeneous follow-up duration preclude causal conclusions regarding DBS or the temporal course of improvement.
Related
- Nucleus Accumbens-Anterior Limb of Internal Capsule Deep Brain Stimulation for Treatment-Resistant Schizophrenia: An Open-label Pilot Study
- Patient-specific subnetwork connectivity predicts deep brain stimulation response in obsessive-compulsive disorder
- Assessing the effect of subthalamic stimulation on metaperception in obsessive-compulsive disorder
- Obsessive–Compulsive Disorder: Comorbidity, Biomarkers, Circuits, and Treatment Strategies
- Reduced cortical thickness in obsessive-compulsive disorder and candidate molecular correlates
BibTeX
@article{cidrodriguez2026longterm,
title = {{Long-term outcomes of nucleus accumbens/anterior limb of the internal capsule deep brain stimulation in treatment-resistant obsessive-compulsive disorder}},
author = {Fátima Ximena Cid-Rodríguez and Rabea Schmahl and René Márquez-Franco and Petra Heiden and Marvin Antonio Soriano-Ursúa and Wencke Wagemann and Daniel Huys and Juan C. Baldermann and Jens Kuhn and Veerle Visser-Vandewalle and Pablo Andrade},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1905823},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1905823/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Long-term outcomes of nucleus accumbens/anterior limb of the internal capsule deep brain stimulation in treatment-resistant obsessive-compulsive disorder
AU - Fátima Ximena Cid-Rodríguez
AU - Rabea Schmahl
AU - René Márquez-Franco
AU - Petra Heiden
AU - Marvin Antonio Soriano-Ursúa
AU - Wencke Wagemann
AU - Daniel Huys
AU - Juan C. Baldermann
AU - Jens Kuhn
AU - Veerle Visser-Vandewalle
AU - Pablo Andrade
PY - 2026
DA - 2026/10/19
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1905823
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1905823/full
AB - Background: Deep brain stimulation (DBS) is a therapeutic option for carefully selected patients with severe, treatment-resistant obsessive-compulsive disorder (OCD), but very long-term outcomes remain insufficiently characterized. We evaluated clinical outcomes after DBS targeting the nucleus accumbens/anterior limb of the internal capsule (NAcc/ALIC) over 3–21 years and described the trajectories of early responders, delayed responders, and non-responders. Methods: This single-center retrospective cohort included 30 consecutive patients (17 women) who underwent NAcc/ALIC DBS between 2004 and 2022. Outcomes were assessed with the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) at baseline (T0), 1 year after surgery (T1), and the latest follow-up at ≥3 years (T2). Response was defined as a ≥35% reduction from baseline. Repeated-measures ANOVA with Bonferroni-adjusted pairwise comparisons was used to assess changes over time. Results: Y-BOCS scores decreased significantly across T0, T1, and T2. At T2, 22 of 30 patients (73.3%) met the response criterion; eight were delayed responders. Of the 15 patients who met the response criterion at T1, 14 retained it at T2 and 1 did not. Conclusion: Clinically meaningful improvement was sustained at long-term follow-up, and some patients who had not responded after 1 year met the response criterion later. Once response was achieved, subsequent loss of response appeared uncommon in this cohort. The retrospective design and heterogeneous follow-up duration preclude causal conclusions regarding DBS or the temporal course of improvement.
SN - 1664-0640
ER -