Webinar on Compulsivity, impulsivity and attention
Sprekers: Ingo Willuhn & Martijn Figee
Recorded on December 16, 2021
Exploring the brain mechanisms of deep-brain stimulation in a rodent model for OCD
Ingo Willuhn, Associate Professor and Principal Investigator at the Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Group Leader at the Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences
Electrical high-frequency deep-brain stimulation (DBS) of the internal capsule (IC) is an effective therapy for otherwise treatment-resistant patients suffering from different psychiatric disorders, most notably obsessive-compulsive disorder (OCD). Although IC-DBS significantly ameliorates symptoms, optimization of individual stimulation parameters is a process that often requires many months. Moreover, the neural mechanism of action for the therapeutic success of DBS in OCD is largely unknown. To explore the fundamentals of DBS action in the brain and to improve DBS therapy in the long run, we used a mouse model for OCD that captures key elements of OCD. We investigated brain mechanisms underlying IC-DBS by systematically varying different DBS parameters that are typically altered in the clinics to optimize treatment outcome, while simultaneously monitoring compulsive behavior and neuronal activity in OCD-relevant brain regions. We identify several general functional principles of IC-DBS that lay the foundation to a more complete understanding of DBS mechanisms of action.
Personalized Deep Brain Stimulation for Obsessive-Compulsive Disorder
Martijn Figee, MD, PhD, Associate Professor, Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai
Deep Brain Stimulation (DBS) research is currently experiencing a paradigm shift away from the focal effects of stimulation on the target anatomical structure toward its impact on distributed brain networks. The most commonly used DBS target for obsessive-compulsive disorder (OCD), the anterior limb of the internal capsule (ALIC), impacts distributed brain networks for reward processing, error salience and inhibitory control. These networks include ALIC-projections to the orbitofrontal cortex, dorsal anterior cingulate cortex and ventrolateral and dorsolateral prefrontal cortex. The recent development of directional segmented DBS leads may allow for selective stimulation of these cortical projections. In this presentation, I will discuss directional white matter tractography stimulation models in OCD patients with ALIC DBS identifying which projections are most therapeutic. These circuit-response maps can be used to guide personalized neuromoduation for OCD and other cross-diagnostic symptom domains involving these circuits.