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Decrease of Prefrontal Metabolism After Subthalamic Stimulation in Obsessive-Compulsive Disorder: A Positron Emission Tomography Study

Florence Le Jeune 1 Marc Vérin 1 Karim N'Diaye 2 Dominique Drapier 3 Emmanuelle Leray 4, 5, 6 Sophie Tezenas Du Montcel 7 Nicolas Baup 8 Antoine Pelissolo 9 Mircea Polosan 10 Luc Mallet 11 Jerome Yelnik 11 Bertrand Devaux 12 Denys Fontaine Isabelle Chéreau 13 Aurélie Bourguignon 1 Julie Péron 14 Paul Sauleau 1 Sylvie Raoul 15 Etienne Garin 16 Marie-Odile Krebs 8 Nematollah Jaafari 17 Bruno Millet 18 
Abstract : Background: High-frequency bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is a promising treatment in refractory obsessive-compulsive disorder (OCD). Method Using the crossover, randomized, and double-blind procedure adopted by the STOC study, 10 patients treated with high-frequency bilateral STN DBS underwent am 18-fluorodeoxyglucose positron emission tomography (PET) investigation to highlight the neural substratum of this therapeutic approach. Results The median YaleBrown Obsessive Compulsive Scale (Y-BOCS) scores for all 10 patients were 31 (minimum = 18, maximum = 36) with "Off-Stimulation" status and 19 (minimum = 0, maximum = 30) with "On-Stimulation" status (p = .05). The OCD patients in Off-Stimulation status showed a hypermetabolism in the right frontal middle and superior gyri, right parietal lobe, postcentral gyrus, and bilateral putamen compared with healthy control subjects. A significant decrease in cerebral metabolism was observed in the left cingulate gyrus and the left frontal medial gyrus in On-Stimulation conditions compared with Off-Stimulation conditions. In addition, the improvement assessed by Y-BOCS scores during the On-Stimulation conditions was positively correlated with PET signal changes at the boundary of the orbitofrontal cortex and the medial prefrontal cortex, between PET signal changes and the Y-BOCS scores modifications in On-Stimulation status. Conclusion This study suggests that the therapeutic effect of STN DBS is related to a decrease in prefrontal cortex metabolism. © 2010 Society of Biological Psychiatry.
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Submitted on : Monday, January 13, 2020 - 3:31:50 PM
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Florence Le Jeune, Marc Vérin, Karim N'Diaye, Dominique Drapier, Emmanuelle Leray, et al.. Decrease of Prefrontal Metabolism After Subthalamic Stimulation in Obsessive-Compulsive Disorder: A Positron Emission Tomography Study. Biological Psychiatry, Elsevier, 2010, 68 (11), pp.1016-1022. ⟨10.1016/j.biopsych.2010.06.033⟩. ⟨hal-02437131⟩



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