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Klinische Neurophysiologie 2014; 45(02): 118-121
DOI: 10.1055/s-0034-1374624
Originalia
© Georg Thieme Verlag KG Stuttgart · New York

Tiefe Hirnstimulation bei Zwangsstörungen

Deep Brain Stimulation in Obsessive Compulsive Disorder
L. Wojtecki
1   Neurologische Klinik, Bewegungsstörungen und Neuromodulation & Institut für Klinische Neurowissenschaften und ­Medizinischen Psychologie, Universitätsklinik Düsseldorf
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Publikationsverlauf

Publikationsdatum:
01. Juli 2014 (online)

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Zusammenfassung

Die Zwangsstörung ist die erste psychiatrische Erkrankung, für die eine offizielle CE-Zertifizierung und FDA-Zulassung als Humanitarian Device Exemption (HDE) zur Behandlung mittels Tiefer Hirnstimulation vorliegt. Die offizielle Indikation ist die Stimulation der vorderen inneren Kapsel zur Behandlung von chronischer, schwerer, therapieresistenter obsessiv-kompulsiver Erkrankung bei Erwachsenen. Die Stimulation benachbarter Gebiete der ventralen Capsula/des ventralen Striatums und des Nucleus accumbens scheint hinsichtlich der Wirksamkeit von Belang zu sein. Ferner liegen positive Daten zur Stimulation anderer Zielgebiete wie dem Nuclues subthalamicus vor. Die Evidenzlage ist noch nicht ausreichend für die abschließende Bewertung der Zielpunkte. Prospektive Studien zum Vergleich der Zielpunkte laufen.

Abstract

Treatment of obsessive compulsive disorder (OCD) is the first CE-marked and FDA approved psychiatric indication for deep brain stimulation. Severe chronic, therapy-refractive OCD in adults has become an official indication for stimulation of the anterior limb of the internal capsule. Stimulation of the ventral capsula/ventral striatum/Ncl. accumbens seems to play a key role in that target area. Stimulation of the subthalamic nucleus seems to be also beneficial. More evidence for the most efficient target is emerging through upcoming trials that compare different targets.

Schlüsselwörter

Tiefe Hirnstimulation - Zwangsstörung - OCD

Key words

deep brain stimulation - obsessive compulsive ­disorder - OCD
 

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