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Clinicians have been asking about the availability of deep brain stimulation (DBS) for patients with highly refractory obsessive-compulsive disorder (OCD) or depression (JW Psychiatry Dec 29 2008). This consensus conference of investigators in the field raises cautions about adopting DBS into the standard armamentarium.
According to the authors, only about 100 patients with refractory OCD and fewer than 25 with refractory depression have received carefully observed DBS for which results have been published. Investigators have used functional neuroimaging to define theoretical targets for the electrode (i.e., limbic and striatal circuits, including the internal capsule and the subgenual cingulate cortex), but the optimal location for implanta…