Aouizerate Bruno, Cuny Emmanuel, Bardinet Eric, Yelnik Jerome, Martin-Guehl Corinne, Rotge Jean-Yves, Rougier Alain, Bioulac Bernard, Tignol Jean, Mallet Luc, Burbaud Pierre, Guehl Dominique
Service de Psychiatrie, Université Victor Segalen Bordeaux 2, Centre Hospitalier Charles Perrens, Centre Carreire, France.
J Neurosurg. 2009 Oct;111(4):775-9. doi: 10.3171/2009.2.JNS0881.
The ventral striatum, including the head of the caudate nucleus and the nucleus accumbens, is a putative target for deep brain stimulation (DBS) in the treatment of obsessive-compulsive disorder (OCD) and major depression (MD). However, the respective roles of these structures in the pathophysiology of OCD and MD remain to be clarified. To address this issue, DBS of the ventral striatum was tested in 2 patients with severely distressing and intractable forms of OCD and MD. Comparisons of clinical outcomes and anatomical data on electrode positioning showed that caudate nucleus stimulation preferentially alleviated OCD manifestations, whereas nucleus accumbens stimulation improved depressive symptoms. These findings suggest that the caudate nucleus and nucleus accumbens participate differently in the pathogenesis of both of these psychiatric conditions.
腹侧纹状体，包括尾状核头部和伏隔核，是治疗强迫症（OCD）和重度抑郁症（MD）时深部脑刺激（DBS）的假定靶点。然而，这些结构在OCD和MD病理生理学中的各自作用仍有待阐明。为解决这一问题，对2例患有严重痛苦且难治性OCD和MD的患者进行了腹侧纹状体DBS测试。临床结果和电极定位解剖数据的比较表明，刺激尾状核可优先缓解OCD表现，而刺激伏隔核可改善抑郁症状。这些发现表明，尾状核和伏隔核在这两种精神疾病的发病机制中发挥着不同的作用。
