Decrease of prefrontal metabolism after subthalamic stimulation in obsessive-compulsive disorder: a positron emission tomography study.

Abstract : BACKGROUND: High-frequency bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is a promising treatment in refractory obsessive-compulsive disorder (OCD). METHOD: Using the crossover, randomized, and double-blind procedure adopted by the STOC study, 10 patients treated with high-frequency bilateral STN DBS underwent am 18-fluorodeoxyglucose positron emission tomography (PET) investigation to highlight the neural substratum of this therapeutic approach. RESULTS: The median Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores for all 10 patients were 31 (minimum = 18, maximum = 36) with "Off-Stimulation" status and 19 (minimum = 0, maximum = 30) with "On-Stimulation" status (p = .05). The OCD patients in Off-Stimulation status showed a hypermetabolism in the right frontal middle and superior gyri, right parietal lobe, postcentral gyrus, and bilateral putamen compared with healthy control subjects. A significant decrease in cerebral metabolism was observed in the left cingulate gyrus and the left frontal medial gyrus in On-Stimulation conditions compared with Off-Stimulation conditions. In addition, the improvement assessed by Y-BOCS scores during the On-Stimulation conditions was positively correlated with PET signal changes at the boundary of the orbitofrontal cortex and the medial prefrontal cortex, between PET signal changes and the Y-BOCS scores modifications in On-Stimulation status. CONCLUSION: This study suggests that the therapeutic effect of STN DBS is related to a decrease in prefrontal cortex metabolism.
Type de document :
Article dans une revue
Biological Psychiatry, Elsevier, 2010, 68 (11), pp.1016-22. <10.1016/j.biopsych.2010.06.033>
Liste complète des métadonnées


http://www.hal.inserm.fr/inserm-00667511
Contributeur : Olivier David <>
Soumis le : mardi 7 février 2012 - 18:06:56
Dernière modification le : lundi 29 mai 2017 - 15:34:47
Document(s) archivé(s) le : mercredi 14 décembre 2016 - 05:04:40

Fichier

 Accès restreint
Fichier visible le : jamais

Connectez-vous pour demander l'accès au fichier

Identifiants

Collections

Citation

Florence Le Jeune, Marc Vérin, Karim N'Diaye, Dominique Drapier, Emmanuelle Leray, et al.. Decrease of prefrontal metabolism after subthalamic stimulation in obsessive-compulsive disorder: a positron emission tomography study.. Biological Psychiatry, Elsevier, 2010, 68 (11), pp.1016-22. <10.1016/j.biopsych.2010.06.033>. <inserm-00667511>

Partager

Métriques

Consultations de la notice

594