A unified connectomic target for deep brain stimulation in obsessive-compulsive disorder

Ningfei Li (), Juan Carlos Baldermann, Astrid Kibleur, Svenja Treu, Harith Akram, Gavin J. B. Elias, Alexandre Boutet, Andres M. Lozano, Bassam Al-Fatly, Bryan Strange, Juan A. Barcia, Ludvic Zrinzo, Eileen Joyce, Stephan Chabardes, Veerle Visser-Vandewalle, Mircea Polosan, Jens Kuhn, Andrea A. Kühn and Andreas Horn
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Ningfei Li: Movement Disorders and Neuromodulation Unit, Department for Neurology
Juan Carlos Baldermann: University of Cologne, Medical Faculty
Astrid Kibleur: Univ. Grenoble Alpes
Svenja Treu: Universidad Politecnica de Madrid
Harith Akram: UCL Queen Square Institute of Neurology
Gavin J. B. Elias: University Health Network
Alexandre Boutet: University Health Network
Andres M. Lozano: University Health Network
Bassam Al-Fatly: Movement Disorders and Neuromodulation Unit, Department for Neurology
Bryan Strange: Universidad Politecnica de Madrid
Juan A. Barcia: Universidad Complutense de Madrid
Ludvic Zrinzo: UCL Queen Square Institute of Neurology
Eileen Joyce: UCL Queen Square Institute of Neurology
Stephan Chabardes: Univ. Grenoble Alpes
Veerle Visser-Vandewalle: University of Cologne
Mircea Polosan: Univ. Grenoble Alpes
Jens Kuhn: University of Cologne, Medical Faculty
Andrea A. Kühn: Movement Disorders and Neuromodulation Unit, Department for Neurology
Andreas Horn: Movement Disorders and Neuromodulation Unit, Department for Neurology

Nature Communications, 2020, vol. 11, issue 1, 1-12

Abstract: Abstract Multiple surgical targets for treating obsessive-compulsive disorder with deep brain stimulation (DBS) have been proposed. However, different targets may modulate the same neural network responsible for clinical improvement. We analyzed data from four cohorts of patients (N = 50) that underwent DBS to the anterior limb of the internal capsule (ALIC), the nucleus accumbens or the subthalamic nucleus (STN). The same fiber bundle was associated with optimal clinical response in cohorts targeting either structure. This bundle connected frontal regions to the STN. When informing the tract target based on the first cohort, clinical improvements in the second could be significantly predicted, and vice versa. To further confirm results, clinical improvements in eight patients from a third center and six patients from a fourth center were significantly predicted based on their stimulation overlap with this tract. Our results show that connectivity-derived models may inform clinical improvements across DBS targets, surgeons and centers. The identified tract target is openly available in atlas form.

Date: 2020
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DOI: 10.1038/s41467-020-16734-3

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