Deep Brain Stimulation (DBS) is a new surgical procedure in which electrodes are placed directly into specific targets in the patient’s brain. Electricity is supplied to the electrodes via thin wires that run through the skull and down the neck, connecting to a battery implant and control circuitry in the chest. By introducing an electrical signal in local areas of the brain, it is possible to interfere with brain activity and reduce symptoms. DBS was first used in 1987 and is already an established procedure for treating Parkinson’s and related motor diseases. It is now used to treat severe cases of Obsessive-Compulsive Disorder (OCD).
OCD is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these actions provides only temporary relief, but not performing them markedly increases anxiety.
In 2009, the FDA granted limited humanitarian approval for Deep Brain Stimulation (DBS) for obsessive-compulsive disorder, the first such approval for a psychiatric illness. Human device exemptions (HDEs) facilitate the development of medical devices intended to treat or diagnose a disease or condition affecting fewer than 4,000 people per year in the United States.
The approval of the HDE was based on a review of data from 26 patients with severe treatment-resistant OCD who underwent the deep brain stimulation at four sites. On average, patients had a 40 percent reduction in their symptoms after 12 months of therapy.
South Carolina Medicare has issued a blanket approval for the use of DBS to treat OCD, making the procedure more affordable for many patients.