Double blind randomized controlled trial of deep brain stimulation for obsessive-compulsive disorder: Clinical trial design

Nicole C.R. McLaughlin, Darin D. Dougherty, Emad Eskandar, Herbert Ward, Kelly D. Foote, Donald A. Malone, Andre Machado, William Wong, Mark Sedrak, Wayne Goodman, Brian H. Kopell, Fuad Issa, Donald C. Shields, Osama A. Abulseoud, Kendall Lee, Mark A. Frye, Alik S. Widge, Thilo Deckersbach, Michael S. Okun, Dawn BowersRussell M. Bauer, Dana Mason, Cynthia S. Kubu, Ivan Bernstein, Kyle Lapidus, David L. Rosenthal, Robert L. Jenkins, Cynthia Read, Paul F. Malloy, Stephen Salloway, David R. Strong, Richard N. Jones, Steven A. Rasmussen, Benjamin D. Greenberg

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Obsessive-compulsive disorder (OCD), a leading cause of disability, affects ~1–2% of the population, and can be distressing and disabling. About 1/3 of individuals demonstrate poor responsiveness to conventional treatments. A small proportion of these individuals may be deep brain stimulation (DBS) candidates. Candidacy is assessed through a multidisciplinary process including assessment of illness severity, chronicity, and functional impact. Optimization failure, despite multiple treatments, is critical during screening. Few patients nationwide are eligible for OCD DBS and thus a multi-center approach was necessary to obtain adequate sample size. The study was conducted over a six-year period and was a NIH-funded, eight-center sham-controlled trial of DBS targeting the ventral capsule/ventral striatum (VC/VS) region. There were 269 individuals who initially contacted the sites, in order to achieve 27 participants enrolled. Study enrollment required extensive review for eligibility, which was overseen by an independent advisory board. Disabling OCD had to be persistent for ≥5 years despite exhaustive medication and behavioral treatment. The final cohort was derived from a detailed consent process that included consent monitoring. Mean illness duration was 27.2 years. OCD symptom subtypes and psychiatric comorbidities varied, but all had severe disability with impaired quality of life and functioning. Participants were randomized to receive sham or active DBS for three months. Following this period, all participants received active DBS. Treatment assignment was masked to participants and raters and assessments were blinded. The final sample was consistent in demographic characteristics and clinical features when compared to other contemporary published prospective studies of OCD DBS. We report the clinical trial design, methods, and general demographics of this OCD DBS sample.

Original languageEnglish (US)
Article number100785
JournalContemporary Clinical Trials Communications
Volume22
DOIs
StatePublished - Jun 2021
Externally publishedYes

Keywords

  • Deep brain stimulation
  • Neurosurgery
  • Obsessive-compulsive disorder
  • Psychiatry

ASJC Scopus subject areas

  • Pharmacology

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