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A unified connectomic target for deep brain stimulation in obsessive-compulsive disorder

Author

Listed:
  • Ningfei Li

    (Movement Disorders and Neuromodulation Unit, Department for Neurology)

  • Juan Carlos Baldermann

    (University of Cologne, Medical Faculty)

  • Astrid Kibleur

    (Univ. Grenoble Alpes
    OpenMind Innovation)

  • Svenja Treu

    (Universidad Politecnica de Madrid)

  • Harith Akram

    (UCL Queen Square Institute of Neurology
    UCL Queen Square Institute of Neurology)

  • Gavin J. B. Elias

    (University Health Network)

  • Alexandre Boutet

    (University Health Network
    University of Toronto)

  • Andres M. Lozano

    (University Health Network)

  • Bassam Al-Fatly

    (Movement Disorders and Neuromodulation Unit, Department for Neurology)

  • Bryan Strange

    (Universidad Politecnica de Madrid)

  • Juan A. Barcia

    (Universidad Complutense de Madrid)

  • Ludvic Zrinzo

    (UCL Queen Square Institute of Neurology
    UCL Queen Square Institute of Neurology)

  • Eileen Joyce

    (UCL Queen Square Institute of Neurology
    UCL Queen Square Institute of Neurology)

  • Stephan Chabardes

    (Univ. Grenoble Alpes)

  • Veerle Visser-Vandewalle

    (University of Cologne)

  • Mircea Polosan

    (Univ. Grenoble Alpes
    Grenoble Institut des Neurosciences
    CHU Grenoble Alpes)

  • Jens Kuhn

    (University of Cologne, Medical Faculty
    Johanniter Hospital Oberhausen)

  • Andrea A. Kühn

    (Movement Disorders and Neuromodulation Unit, Department for Neurology)

  • Andreas Horn

    (Movement Disorders and Neuromodulation Unit, Department for Neurology)

Abstract

Multiple surgical targets for treating obsessive-compulsive disorder with deep brain stimulation (DBS) have been proposed. However, different targets may modulate the same neural network responsible for clinical improvement. We analyzed data from four cohorts of patients (N = 50) that underwent DBS to the anterior limb of the internal capsule (ALIC), the nucleus accumbens or the subthalamic nucleus (STN). The same fiber bundle was associated with optimal clinical response in cohorts targeting either structure. This bundle connected frontal regions to the STN. When informing the tract target based on the first cohort, clinical improvements in the second could be significantly predicted, and vice versa. To further confirm results, clinical improvements in eight patients from a third center and six patients from a fourth center were significantly predicted based on their stimulation overlap with this tract. Our results show that connectivity-derived models may inform clinical improvements across DBS targets, surgeons and centers. The identified tract target is openly available in atlas form.

Suggested Citation

  • Ningfei Li & Juan Carlos Baldermann & Astrid Kibleur & Svenja Treu & Harith Akram & Gavin J. B. Elias & Alexandre Boutet & Andres M. Lozano & Bassam Al-Fatly & Bryan Strange & Juan A. Barcia & Ludvic , 2020. "A unified connectomic target for deep brain stimulation in obsessive-compulsive disorder," Nature Communications, Nature, vol. 11(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:11:y:2020:i:1:d:10.1038_s41467-020-16734-3
    DOI: 10.1038/s41467-020-16734-3
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