Fridgeirsson Egill A, Bais Melisse N, Eijsker Nadine, Thomas Rajat M, Smit Dirk J A, Bergfeld Isidoor O, Schuurman P Richard, van den Munckhof Pepijn, de Koning Pelle, Vulink Nienke, Figee Martijn, Mazaheri Ali, van Wingen Guido A, Denys Damiaan
Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam Neuroscience, Amsterdam, The Netherlands.
J Neural Eng. 2023 Mar 10;20(2). doi: 10.1088/1741-2552/acbee1.
. Deep brain stimulation is a treatment option for patients with refractory obsessive-compulsive disorder. A new generation of stimulators hold promise for closed loop stimulation, with adaptive stimulation in response to biologic signals. Here we aimed to discover a suitable biomarker in the ventral striatum in patients with obsessive compulsive disorder using local field potentials.We induced obsessions and compulsions in 11 patients undergoing deep brain stimulation treatment using a symptom provocation task. Then we trained machine learning models to predict symptoms using the recorded intracranial signal from the deep brain stimulation electrodes.Average areas under the receiver operating characteristics curve were 62.1% for obsessions and 78.2% for compulsions for patient specific models. For obsessions it reached over 85% in one patient, whereas performance was near chance level when the model was trained across patients. Optimal performances for obsessions and compulsions was obtained at different recording sites.. The results from this study suggest that closed loop stimulation may be a viable option for obsessive-compulsive disorder, but that intracranial biomarkers are patient and not disorder specific.Netherlands trial registry NL7486.
深部脑刺激是难治性强迫症患者的一种治疗选择。新一代刺激器有望实现闭环刺激，即根据生物信号进行适应性刺激。在此，我们旨在利用局部场电位在强迫症患者的腹侧纹状体中发现合适的生物标志物。我们使用症状激发任务，在11名接受深部脑刺激治疗的患者中诱发强迫观念和强迫行为。然后，我们训练机器学习模型，利用从深部脑刺激电极记录的颅内信号来预测症状。针对患者特异性模型，强迫观念的受试者操作特征曲线下平均面积为62.1%，强迫行为为78.2%。在一名患者中，强迫观念的预测准确率超过85%，而当模型在所有患者中进行训练时，表现接近随机水平。在不同记录部位获得了强迫观念和强迫行为的最佳表现。本研究结果表明，闭环刺激可能是强迫症的一种可行治疗选择，但颅内生物标志物是因人而异的，而非针对特定疾病。荷兰试验注册编号NL7486。
