Quality Analysis Of Deep Brain Stimulation For Obsessive-Compulsive Disorder Using A Neuropsychological Assessment Battery

Abstract Objective We completed a case study to investigate whether there are cognitive changes after Deep Brain Stimulation (DBS) surgery in the treatment of refractory Obsessive–Compulsive Disorder (OCD) as an initiation of a quality analysis due to increased referrals for this procedure at our institution. Method We evaluated a 21-year-old male before and after bilateral nucleus accumbens DBS placement for OCD. His pre-operative neurosurgery evaluation and brain imaging were unremarkable. Post-operative imaging revealed stable changes of bilateral DBS lead placement. Pre and post-operative neuropsychological testing included measures of mental status, language, memory, attention, and executive functioning. Results A reliable change estimate was obtained for each test. There was no significant change in performance on the Mini-Mental State Exam, Boston Naming Test, Logical Memory I/II, Faces I, Rey Complex Figure Test (RCFT) immediate and delayed recall, Wisconsin Card Sorting Test-64, Trail Making Tests A & B, Letter Fluency, Animal Fluency, and Stroop Color and Word Test (Stroop) color and color-word condition. There was significant decline for all California Verbal Learning Test-Second Edition trials (trials 1–5, short delay recall, and long delay recall) and RCFT recognition. There was significant improvement for the Stroop word condition. Conclusions. Given mixed findings, it is unclear the extent to which DBS impacted this patient’s overall cognitive functioning. Meanwhile, he showed improvement in OCD symptoms, to the degree that he could live alone, maintain employment, and independently manage daily activities. There is need for future studies to examine the cognitive effects of DBS for OCD, with larger samples and a control group.