Tractography-Guided Deep Brain Stimulation of the Anteromedial Globus Pallidus Internus for Refractory Obsessive-Compulsive Disorder: Case Report Azriel, A, Farrand, S, Di Biase, M, Zalesky, A, Lui, E, Desmond, P, Evans, A, Awad, M, Moscovici, S, Velakoulis, D and Bittar, Richard 2020, Tractography-Guided Deep Brain Stimulation of the Anteromedial Globus Pallidus Internus for Refractory Obsessive-Compulsive Disorder: Case Report, Neurosurgery, vol. 86, no. 6, pp. E558-E563, doi: 10.1093/neuros/nyz285. Attached Files Name Description MIMEType Size Downloads Title Tractography-Guided Deep Brain Stimulation of the Anteromedial Globus Pallidus Internus for Refractory Obsessive-Compulsive Disorder: Case Report Author(s) Azriel, A Farrand, S Di Biase, M Zalesky, A Lui, E Desmond, P Evans, A Awad, M Moscovici, S Velakoulis, D Bittar, Richard Journal name Neurosurgery Volume number 86 Issue number 6 Start page E558 End page E563 Total pages 6 Publisher Oxford University Press Place of publication Oxford, Eng. Publication date 2020-06 ISSN 0148-396X 1524-4040 Keyword(s) Anteromedial globus pallidus internus Deep brain stimulation Obsessive-compulsive disorder Tractography Summary BACKGROUND AND IMPORTANCE: Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, mainly treated with psychotherapy and pharmacotherapy. Surgical intervention may be appropriate for patients with treatment-refractory OCD. Deep brain stimulation (DBS) is an alternative for previously common ablative surgical procedures. Tractography has been proposed as a method for individualizing DBS treatment and may have the potential to improve efficacy. CLINICAL PRESENTATION: We present a patient with treatment-refractory OCD previously treated with bilateral leucotomies, who underwent DBS surgery with targeting informed by tractography. Preoperative tractography to identify suitable DBS targets was undertaken. Structural images were also utilized for standard stereotactic surgical planning. The anteromedial globus pallidus internus (amGPi) was chosen as the target bilaterally after consideration of white matter projections to frontal cortical regions and neurosurgical approach. Bilateral amGPi DBS surgery was undertaken without adverse events. At 16-mo follow-up, there was a 48.5% reduction in OCD symptom severity as measured by the Yale-Brown Obsessive Compulsive Scale. CONCLUSION: The amGPi can be a successful DBS target for OCD. This is the first known case to report on DBS surgery postleucotomies for OCD and highlights the utility of tractography for surgical planning in OCD Language eng DOI 10.1093/neuros/nyz285 Field of Research 1103 Clinical Sciences 1109 Neurosciences HERDC Research category C1 Refereed article in a scholarly journal Persistent URL http://hdl.handle.net/10536/DRO/DU:30158652 Document type: Journal Article Collections: Faculty of Health School of Psychology Related Links Link Description Connect to published version Go to link with your DU access privileges   Connect to Elements publication management system Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Versions Version Filter Type Thu, 18 Nov 2021, 10:21:21 EST Thu, 18 Nov 2021, 16:03:19 EST Fri, 19 Nov 2021, 07:14:23 EST Fri, 26 Nov 2021, 15:11:27 EST Fri, 14 Jan 2022, 12:45:24 EST Fri, 14 Jan 2022, 15:27:11 EST Fri, 14 Jan 2022, 15:31:27 EST Filtered Full Citation counts:   Cited 0 times in TR Web of Science Cited 5 times in Scopus Search Google Scholar Access Statistics: 14 Abstract Views, 0 File Downloads  -  Detailed Statistics Created: Thu, 18 Nov 2021, 10:21:21 EST