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Deep brain stimulation restores frontostriatal network activity in obsessive-compulsive disorder

An Addendum to this article was published on 26 August 2014

This article has been updated

Abstract

Little is known about the underlying neural mechanism of deep brain stimulation (DBS). We found that DBS targeted at the nucleus accumbens (NAc) normalized NAc activity, reduced excessive connectivity between the NAc and prefrontal cortex, and decreased frontal low-frequency oscillations during symptom provocation in patients with obsessive-compulsive disorder. Our findings suggest that DBS is able to reduce maladaptive activity and connectivity of the stimulated region.

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Figure 1: DBS normalizes brain activity in the NAc.
Figure 2: DBS normalizes excessive frontostriatal connectivity.
Figure 3: DBS modulates frontal low-frequency EEG oscillations in response to disease-related symptom-provoking stimuli.

Change history

  • 18 July 2014

     Reanalysis accounting for electrode artifacts. The newly published Supplementary Figure 6 depicts normalized EPI scans from two DBS-implanted subjects illustrating that the nucleus accumbens ROI (red) and the region of signal dropout around the electrode are not overlapping. Nevertheless, we reanalyzed our data to further rule out the possibility that our results were affected by signal measured from the dropout region. We re-analyzed the data by removing the parts of the ROI that would extend into the electrode dropout region based on the normalized but unsmoothed functional images instead of T1-weighted scans. We then extracted the ROI time series from these unsmoothed images and correlated these with the smoothed remaining brain. Results from this reanalysis (Supplementary Table 6 and Supplementary Fig. 7) are similar to those of the first analysis—that is, DBS-induced decrease in functional connectivity between the NAc and mPFC/lPFC—confirming that our results are unlikely to reflect false positives related to electrode artifacts.

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Acknowledgements

This study was supported by grant 916.66.095 from the Netherlands Organization for Scientific Research ZON-MW VENI program. A.M. was supported from a VENI grant 016.115.196 from the Netherlands Organization for Scientific Research.

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Authors and Affiliations

Authors

Contributions

D.D. and M.F. conceived the study. M.F., R.S., C.-E.V.-A., A.N. and M.V. designed experiments. M.F., J.L. and B.d.K. conducted functional neuroimaging. M.F., J.L., M.V. and L.D. carried out neuroimaging data processing and analysis. R.S., N.L. and C.-E.V.-A. conducted EEG recording, data processing and analysis. N.V., P.d.K., M.M. and P.O. acquired behavioral data. P.v.d.M. and P.R.S. performed neurosurgery and edited the manuscript. M.F., J.L. and R.S. prepared the manuscript. D.D., W.v.d.B., G.v.W., A.N., P.v.d.M., P.R.S. and A.M. edited the manuscript.

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Correspondence to Martijn Figee or Damiaan Denys.

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Competing interests

P.R.S. is an independent consultant for Medtronic Inc on educational matters and received travel grants from the company.

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Supplementary Figures 1–7 and Supplementary Tables 1–6 (PDF 3103 kb)

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Figee, M., Luigjes, J., Smolders, R. et al. Deep brain stimulation restores frontostriatal network activity in obsessive-compulsive disorder. Nat Neurosci 16, 386–387 (2013). https://doi.org/10.1038/nn.3344

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