Brain stimulation may help OCD patients
By Zachary Lewis
Times-Picayune (New Orleans)
Copyright 2007 The Times-Picayune Publishing Company
CLEVELAND — Obsessive-compulsive disorder nearly destroyed Jennifer Shortridge of Twinsburg, Ohio.
Minor tasks such as showering and tying shoes became frustrating labyrinths of repetitive motions.
Just as frustrating, she found her memory sliding, robbing her of the focus she needed to take control of her life.
Now Shortridge and other OCD patients are finding relief in a treatment originally used for movement disorders such as Parkinson’s disease.
Deep brain stimulation — or DBS — seems to alleviate the symptoms of obsessive-compulsive disorder and, most recently, has helped patients including Shortridge regain their memories.
“I’m using these big words that I couldn’t even spell before,” Shortridge said.
Deep brain stimulation uses a pacemaker device, implanted in the chest with electrodes running to the brain. The device delivers electrical impulses to the brain.
Doctors at the Cleveland Clinic have early evidence suggesting that, besides relieving symptoms, deep brain stimulation helps those with severe depression and OCD remember detailed information.
“If they can’t remember things, then they’re not” focusing, Clinic neurologist Dr. Donald Malone said. “For them, that’s all the time.”
Memory impairment also erodes morale, which hinders other avenues of therapy, Malone said.
Malone is one of eight doctors behind a small, preliminary study of 18 patients, eight of them depressed and 10 with OCD.
All tried traditional medications and cognitive therapies without success.
OCD affects about 1 percent of the U.S. population. Of those, 20 percent are “treatment resistant,” and half of those are disabled. Depression, meanwhile, affects 10 percent to 15 percent of the population, with 10 percent of those severely affected.
All told, “we’re looking at a fairly large population,” Malone said.
In the Cleveland trial, two-thirds of the patients scored 50 percent higher on memory measures after deep brain stimulation.
“That kind of response is pretty significant,” Malone said. “In this group, it’s virtually unheard of.”
Dr. Cynthia Kubu presented the study results at a recent conference of the American Association of Neurological Surgeons in Washington, D.C.
Shortridge said OCD derailed her dream of becoming an emergency medical technician; studying became impossible.
“There were always too many choices,” she said. “I would just reread and reread. You couldn’t even talk to me.”
Medications didn’t help.
Neither did the second line of defense: learning to tolerate discomfort and anxiety. “I was to the point where I was ready to dig my own grave,” Shortridge said.
Then she learned about deep brain stimulation, and on Jan. 5, she said goodbye to her family to travel to Gainesville, Fla., where doctors at Shands Hospital put two electrodes in her brain.
Shands is one of the few facilities that offer the treatment.
The change was sudden and dramatic. “I feel like I grew up overnight,” she said. “You wouldn’t even know it’s the same person.”
Best of all, she said, regaining her memory lets her pick up where she left off. She plans to re-enroll in EMT training and volunteer at a hospital.
Don’t expect the therapy to become popular. Even if further trials persuade the U.S. Food and Drug Administration to approve deep brain stimulation as a “humanitarian device,” it would be used only in the most extreme cases.
Still, the discovery may point to a new range of applications for it, said Dr. Jeremy Greenlee, assistant professor of neurosurgery at the University of Iowa.
“In general, we don’t have a good understanding of how DBS” works, he said. If it improves memory, “that would be an added bonus.”