Editing Deep brain stimulation (section)

=== Obsessive-Compulsive-Disorder ===
DBS for OCD,<ref name=":8">{{Cite journal |last1=Nuttin |first1=Bart |last2=Cosyns |first2=Paul |last3=Demeulemeester |first3=Hilde |last4=Gybels |first4=Jan |last5=Meyerson |first5=Björn |date=October 1999 |title=Electrical stimulation in anterior limbs of internal capsules in patients with obsessive-compulsive disorder |url=https://linkinghub.elsevier.com/retrieve/pii/S0140673699023764 |journal=The Lancet |language=en |volume=354 |issue=9189 |page=1526 |doi=10.1016/S0140-6736(99)02376-4|pmid=10551504 |url-access=subscription }}</ref> Tourette's Syndrome,<ref name="linkinghub.elsevier.com">{{Cite journal |last1=Vandewalle |first1=V |last2=van der Linden |first2=Chr |last3=Groenewegen |first3=Hj |last4=Caemaert |first4=J |date=February 1999 |title=Stereotactic treatment of Gilles de la Tourette syndrome by high frequency stimulation of thalamus |url=https://linkinghub.elsevier.com/retrieve/pii/S0140673698059649 |journal=The Lancet |language=en |volume=353 |issue=9154 |page=724 |doi=10.1016/S0140-6736(98)05964-9|pmid=10073521 |url-access=subscription }}</ref> and dystonia were first completed in 1999.<ref>{{Cite journal |last1=Krauss |first1=Joachim K |last2=Pohle |first2=Thomas |last3=Weber |first3=Sabine |last4=Ozdoba |first4=Christoph |last5=Burgunder |first5=Jean-Marc |date=September 1999 |title=Bilateral stimulation of globus pallidus internus for treatment of cervical dystonia |url=https://linkinghub.elsevier.com/retrieve/pii/S0140673699800221 |journal=The Lancet |language=en |volume=354 |issue=9181 |pages=837–838 |doi=10.1016/S0140-6736(99)80022-1|pmid=10485734 |url-access=subscription }}</ref> The original target studied was the [[anterior limb of the internal capsule]],<ref name=":8" /> though multiple sites have been probed since then. Within the internal capsule, large probabilistic mapping trials have identified two therapeutic sites,<ref>{{Cite journal |last1=Meyer |first1=Garance M. |last2=Hollunder |first2=Barbara |date=July 2024 |title=Deep Brain Stimulation for Obsessive-Compulsive Disorder: Optimal Stimulation Sites |url=https://linkinghub.elsevier.com/retrieve/pii/S0006322323017857 |journal=Biological Psychiatry |language=en |volume=96 |issue=2 |pages=101–113 |doi=10.1016/j.biopsych.2023.12.010 |pmc=11190041 |pmid=38141909|pmc-embargo-date=July 15, 2025 }}</ref> one thought to corresponding to the [[basal ganglia|direct pathway]] in the basal ganglia<ref name="ReferenceA">{{Cite journal |last1=Li |first1=Ningfei |date=2020-07-03 |title=A unified connectomic target for deep brain stimulation in obsessive-compulsive disorder |journal=Nature Communications |language=en |volume=11 |issue=1 |page=3364 |doi=10.1038/s41467-020-16734-3 |issn=2041-1723 |pmc=7335093 |pmid=32620886|bibcode=2020NatCo..11.3364L }}</ref> to the subthalamic nucleus and other midbrain regions, the other [[Indirect pathway|indirect]].

A potential circuit structure that seems to combine most effective targets in both the ALIC and STN region has been identified and termed the OCD response tract, though multiple targets have been probed and found to have effect.<ref name="ReferenceA"/><ref>{{Cite journal |last1=Gadot |first1=Ron |date=July 2024 |title=Tractography-Based Modeling Explains Treatment Outcomes in Patients Undergoing Deep Brain Stimulation for Obsessive-Compulsive Disorder |journal=Biological Psychiatry |language=en |volume=96 |issue=2 |pages=95–100 |doi=10.1016/j.biopsych.2023.01.017 |pmc=10387502 |pmid=36948900}}</ref>

DBS for OCD received a [[humanitarian device exemption]] from the FDA in 2009.<ref>{{Cite web |title=FDA Humanitarian Device Exemption Approval for OCD |url=https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfhde/hde.cfm?id=375533|archive-url=https://web.archive.org/web/20201020021025/https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfhde/hde.cfm?id=375533|url-status=dead|archive-date=October 20, 2020}}</ref> In Europe, the CE Mark for Deep Brain Stimulation (DBS) for Obsessive-Compulsive Disorder (OCD) was active from 2009 to 2022 but not renewed due to a lack of government health coverage.<ref name="nature.com"/><ref>{{Cite journal |last1=Mosley |first1=Philip E |last2=Velakoulis |first2=Dennis |last3=Farrand |first3=Sarah |last4=Marsh |first4=Rodney |last5=Mohan |first5=Adith |last6=Castle |first6=David |last7=Sachdev |first7=Perminder S |date=May 2022 |title=Deep brain stimulation for treatment-refractory obsessive-compulsive disorder should be an accepted therapy in Australia |url=http://journals.sagepub.com/doi/10.1177/00048674211031482 |journal=Australian & New Zealand Journal of Psychiatry |language=en |volume=56 |issue=5 |pages=430–436 |doi=10.1177/00048674211031482 |pmid=34263654 |issn=0004-8674|url-access=subscription }}</ref>