Deep Brain Stimulation for Obsessive-Compulsive Disorder: evolution of tractography-based targeting

COEX 

Deep brain stimulation (DBS) in the anterior limb of the internal capsule (ALIC) for obsessive-compulsive disorder (OCD) can result in large improvements in symptoms and quality of life. However, without a clear stimulation target within the anatomically variable ALIC region, clinical benefits require long trial-and-error periods of parameter optimization.
We report an evolution toward precision ALIC DBS targeting for OCD based on patient-specific tractography. Our aim was to develop a targeting method that would result in a more uniform target location and symptom response pattern. We generated a responder common map of ALIC connectivity and used it to target a new cohort of patients prospectively. To validate our targeting method, we generated a tractography-based stimulation model to predict clinical outcomes.