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Mulders AEP, Plantinga BR, Schruers K, Duits A, Janssen MLF, Ackermans L, Leentjens AFG, Jahanshahi A, Temel Y. Deep brain stimulation of the subthalamic nucleus in obsessive-compulsive disorder: Neuroanatomical and pathophysiological considerations. Eur Neuropsychopharmacol 2016; 26:1909-1919. [PMID: 27838106 DOI: 10.1016/j.euroneuro.2016.10.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/04/2016] [Accepted: 10/29/2016] [Indexed: 11/17/2022]
Abstract
Obsessive-compulsive disorder (OCD) is among the most disabling chronic psychiatric disorders and has a significant negative impact on multiple domains of quality of life. For patients suffering from severe refractory OCD, deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been applied. Reviewing the literature of the last years we believe that through its central position within the cortico-basal ganglia-thalamocortical circuits, the STN has a coordinating role in decision-making and action-selection mechanisms. Dysfunctional information-processing at the level of the STN is responsible for some of the core symptoms of OCD. Research confirms an electrophysiological dysfunction in the associative and limbic (non-motor) parts of the STN. Compared to Parkinson׳s disease patients, STN neurons in OCD exhibit a lower firing rate, less frequent but longer bursts, increased burst activity in the anterior ventromedial area, an asymmetrical left-sided burst distribution, and a predominant oscillatory activity in the δ-band. Moreover, there is direct evidence for the involvement of the STN in both checking behavior and OCD symptoms, which are both related to changes in electrophysiological activity in the non-motor STN. Through a combination of mechanisms, DBS of the STN seems to interrupt the disturbed information-processing, leading to a normalization of connectivity within the cortico-basal ganglia-thalamocortical circuits and consequently to a reduction in symptoms. In conclusion, based on the STN׳s strategic position within cortico-basal ganglia-thalamocortical circuits and its involvement in action-selection mechanisms that are responsible for some of the core symptoms of OCD, the STN is a mechanism-based target for DBS in OCD.
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Affiliation(s)
- A E P Mulders
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - B R Plantinga
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Biomedical Image Analysis, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - K Schruers
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Duits
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M L F Janssen
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - L Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A F G Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Y Temel
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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Chai F, Abdelkarim M, Laurent T, Tabary N, Degoutin S, Simon N, Peters F, Blanchemain N, Martel B, Hildebrand HF. Poly-cyclodextrin functionalized porous bioceramics for local chemotherapy and anticancer bone reconstruction. J Biomed Mater Res B Appl Biomater 2013; 102:1130-9. [DOI: 10.1002/jbm.b.33094] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/29/2013] [Accepted: 12/04/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Feng Chai
- Université Lille Nord de France; Lille France
- Groupe de Recherche sur les Biomatériaux (U 1008 INSERM) Université Lille 2-Faculté de Médecine; Lille France
| | - Mohamed Abdelkarim
- Université Lille Nord de France; Lille France
- Groupe de Recherche sur les Biomatériaux (U 1008 INSERM) Université Lille 2-Faculté de Médecine; Lille France
| | - Thomas Laurent
- Université Lille Nord de France; Lille France
- Unité des Matériaux et Transformations (UMET, UMR 8207), School of Chemistry, Université de Lille 1, Cité Scientifique; Villeneuve d'Ascq France
| | - Nicolas Tabary
- Université Lille Nord de France; Lille France
- Unité des Matériaux et Transformations (UMET, UMR 8207), School of Chemistry, Université de Lille 1, Cité Scientifique; Villeneuve d'Ascq France
| | - Stephanie Degoutin
- Université Lille Nord de France; Lille France
- Unité des Matériaux et Transformations (UMET, UMR 8207), School of Chemistry, Université de Lille 1, Cité Scientifique; Villeneuve d'Ascq France
| | - Nicolas Simon
- Université Lille Nord de France; Lille France
- Unité de Pharmacologie Antitumorale; Centre Oscar Lambret Lille France
- UDSL EA GRIIOT; UFR Pharmacie; Lille France
| | - Fabian Peters
- Curasan AG; Frankfurt Plant; Frankfurt am Main Germany
| | - Nicolas Blanchemain
- Université Lille Nord de France; Lille France
- Groupe de Recherche sur les Biomatériaux (U 1008 INSERM) Université Lille 2-Faculté de Médecine; Lille France
| | - Bernard Martel
- Université Lille Nord de France; Lille France
- Unité des Matériaux et Transformations (UMET, UMR 8207), School of Chemistry, Université de Lille 1, Cité Scientifique; Villeneuve d'Ascq France
| | - Hartmut F. Hildebrand
- Université Lille Nord de France; Lille France
- Groupe de Recherche sur les Biomatériaux (U 1008 INSERM) Université Lille 2-Faculté de Médecine; Lille France
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