Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam Brain and Cognition, Amsterdam, The Netherlands.
Curr Top Behav Neurosci. 2021;49:399-436. doi: 10.1007/7854_2020_206.
It becomes increasingly clear that (non-)invasive neurostimulation is an effective treatment for obsessive-compulsive disorder (OCD). In this chapter we review the available evidence on techniques and targets, clinical results including a meta-analysis, mechanisms of action, and animal research. We focus on deep brain stimulation (DBS), but also cover non-invasive neurostimulation including transcranial magnetic stimulation (TMS). Data shows that most DBS studies target the ventral capsule/ventral striatum (VC/VS), with an overall 76% response rate in treatment-refractory OCD. Also TMS holds clinical promise. Increased insight in the normalizing effects of neurostimulation on cortico-striatal-thalamic-cortical (CSTC) loops - through neuroimaging and animal research - provides novel opportunities to further optimize treatment strategies. Advancing clinical implementation of neurostimulation techniques is essential to ameliorate the lives of the many treatment-refractory OCD patients.
越来越明显的是，（非）侵入性神经刺激是治疗强迫症（OCD）的有效方法。在这一章中，我们回顾了关于技术和靶点的现有证据、包括荟萃分析在内的临床结果、作用机制和动物研究。我们专注于深部脑刺激（DBS），但也涵盖了包括经颅磁刺激（TMS）在内的非侵入性神经刺激。数据表明，大多数 DBS 研究的靶点是腹侧被盖区/腹侧纹状体（VC/VS），在治疗抵抗性 OCD 中总体反应率为 76%。TMS 也具有临床前景。通过神经影像学和动物研究，对神经刺激对皮质-纹状体-丘脑-皮质（CSTC）回路的正常化作用的深入了解，为进一步优化治疗策略提供了新的机会。推进神经刺激技术的临床应用对于改善许多治疗抵抗性 OCD 患者的生活至关重要。
