Yeah, No Journal Club

Neuroscience+Clinical Trial=Effective Treatment of OCD

Episode Summary

In this episode, we explore a recent clinical trial of deep brain stimulation (DBS) for the management of severe, treatment refractory obsessive compulsive disorder (OCD). While this study is very small, the authors explore not only which stimulant sites are most effective in OCD, they also studied what stimulation at each site does on a cognitive level and what neural circuits are altered by the stimulation. Along the way, we think about cognitive flexibility (the ability to change the rules that govern decisions) and whether or not enhancing cognitive flexibility is necessary to effectively treat OCD. We also bask in the glory of this example of translational neuroscience and think about what we know about circuits in other psychiatric illnesses.

Episode Notes

The paper we discuss is H Tyagi et al. (2019) A Randomized Trial Directly Comparing Ventral Capsule and Anteromedial Subthalamic Nucleus Stimulation in Obsessive-Compulsive Disorder: Clinical and Imaging Evidence for Dissociable Effects. Biological Psychiatry 85:726-734.

You can find a copy of the Yale Brown Obsessive Compulsive Scale (Y-BOCS), complete with detailed instructions for administering the scale, here.

A bit more information on the set-shifting/cognitive flexibility task used in the study can be found here.