One-and-a-half-year follow-up after stimulation of nucleus accumbens in a patient with obsessive-compulsive disorder of extreme intensity - a case report

In patients with extreme severity of obsessive-compulsive disorder (OCD), highly resistant to pharmacological treatment, a neurosurgical treatment may be taken into consideration. Among the applied neurosurgical procedures in the last few years, deep brain stimulation (DBS) has emerged as the most promising treatment for such patients, with nucleus accumbens as the most frequent stimulation target. We describe the case of a 35-year-old woman suffering from OCD since 1998, pharmacological treatment-intractable with extreme intensity of the symptoms. She underwent surgical placement of electrodes for deep brain stimulation into the nucleus accumbens, bilaterally. We present 18 months follow-up with symptoms intensity repeatedly evaluated using the Y-BOCS. After 8 months symptoms intensity decreased by about 45% and after 18 months by about 35%. Despite the fluctuations of the patient's general feeling in the covered period, determined by different factors, the general effect of application of the DBS procedure may be accepted as favourable.