Implant may lessen OCD symptoms
A brain implant could help patients with obsessive compulsive disorder get rid of nervous habits the illness triggers, doctors at Allegheny General Hospital said Tuesday.
The battery-operated device is similar to a heart pacemaker and emits electrical signals that alter brain circuits, said Dr. Donald Whiting, a neurosurgeon who implanted the device in a 57-year-old woman from Mt. Lebanon. The woman, who declined to be identified, is showing gradual signs of improvement after the May surgery, Whiting said.
"This gives us another option that can help patients get better and cut the medications they take," said Whiting, vice chairman of neurosurgery at the North Side hospital. "It's really a treatment that is in its infancy but has the potential to be very successful."
The Food and Drug Administration approved the device last year after a study of 26 patients showed a 40 percent reduction of symptoms in patients with severe obsessive compulsive disorder.
According to the National Institute of Mental Health, about 2.2 million Americans suffer from OCD, which causes unwanted, repetitive behaviors and thoughts. People with the disorder often engage in rituals such as continuous handwashing or checking things repeatedly.
Dr. Alicia Kaplan, an Allegheny General psychiatrist who works with OCD patients, cautioned that the deep-brain stimulation is not for all patients. It specifically is designed for people who have exhausted standard drug treatments and in some cases have taken high doses of antidepressants.
"It's really reserved for those patients where OCD is so severe that they have no quality of life," Kaplan said. Those patients are so obsessed with thoughts and rituals that they cannot hold jobs or interact with people, she said.
The device consists of a thin wire, an extension and a neurostimulator that are implanted near the collarbone. Electrical impulses from the neurostimulator follow the extension into the brain. The same technique has been used for more than a decade to treat patients with Parkinson's disease, tremors and dystonia, a movement disorder that causes involuntary contractions of the muscles.
The electrical signals are continuously adjusted as symptoms gradually decrease. This process can take months and is not always effective, Whiting said.
Doctors are adjusting settings in the device implanted in the Mt. Lebanon woman.
"We've had ups and downs, but we are seeing some benefits," he said.
If the device proves successful, patients could decrease the amount of medications they take. That could be helpful, Kaplan said, because most drugs used to treat obsessive compulsive disorder produce side effects.
