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Multiple surgical targets for treating obsessive-compulsive disorder with deep brain stimulation (DBS) have been proposed. However, different targets may modulate the same neural network responsible for clinical improvement. We analyzed data from four cohorts of patients (N = 50) that underwent DBS to the anterior limb of the internal capsule (ALIC), the nucleus accumbens or the subthalamic nucleus (STN). The same fiber bundle was associated with optimal clinical response in cohorts targeting either structure. This bundle connected frontal regions to the STN. When informing the tract target based on the first cohort, clinical improvements in the second could be significantly predicted, and vice versa. To further confirm results, clinical improvements in eight patients from a third center and six patients from a fourth center were significantly predicted based on their stimulation overlap with this tract. Our results show that connectivity-derived models may inform clinical improvements across DBS targets, surgeons and centers. The identified tract target is openly available in atlas form.
Li et al. analyzed structural connectivity of deep brain stimulation electrodes in 50 patients suffering from obsessive-compulsive disorder operated at four centers. Connectivity to a specific tract within the anterior limb of the internal capsule was associated with optimal treatment response across cohorts, surgeons and centers.
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; Baldermann, Juan Carlos 2 ; Kibleur Astrid 3 ; Treu Svenja 4 ; Harith, Akram 5
; Elias Gavin J B 6 ; Boutet Alexandre 7
; Lozano, Andres M 6 ; Al-Fatly, Bassam 8
; Strange, Bryan 4
; Barcia, Juan A 9 ; Ludvic, Zrinzo 5
; Joyce, Eileen 5
; Chabardes Stephan 10 ; Visser-Vandewalle Veerle 11 ; Polosan Mircea 12 ; Kuhn, Jens 13 ; Kühn, Andrea A 14 ; Horn, Andreas 14
1 Movement Disorders and Neuromodulation Unit, Department for Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
2 University of Cologne, Medical Faculty, Department of Psychiatry and Psychotherapy, Department of Neurology, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777)
3 Univ. Grenoble Alpes, Grenoble, France (GRID:grid.450307.5); OpenMind Innovation, Paris, France (GRID:grid.450307.5)
4 Universidad Politecnica de Madrid, Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Madrid, Spain (GRID:grid.5690.a) (ISNI:0000 0001 2151 2978)
5 UCL Queen Square Institute of Neurology, Department of Clinical and Movement Neurosciences, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201); UCL Queen Square Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201)
6 University Health Network, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428)
7 University Health Network, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); University of Toronto, Joint Department of Medical Imaging, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
8 Movement Disorders and Neuromodulation Unit, Department for Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany (GRID:grid.231844.8)
9 Universidad Complutense de Madrid, Hospital Clínico San Carlos, Neurosurgery Department, Madrid, Spain (GRID:grid.4795.f) (ISNI:0000 0001 2157 7667)
10 Univ. Grenoble Alpes, Grenoble, France (GRID:grid.450307.5)
11 University of Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777)
12 Univ. Grenoble Alpes, Grenoble, France (GRID:grid.450307.5); Grenoble Institut des Neurosciences, Inserm, U1216, Grenoble, France (GRID:grid.462307.4) (ISNI:0000 0004 0429 3736); CHU Grenoble Alpes, Psychiatry Department, Grenoble, France (GRID:grid.410529.b) (ISNI:0000 0001 0792 4829)
13 University of Cologne, Medical Faculty, Department of Psychiatry and Psychotherapy, Department of Neurology, Cologne, Germany (GRID:grid.6190.e) (ISNI:0000 0000 8580 3777); Johanniter Hospital Oberhausen, Department of Psychiatry, Psychotherapy and Psychosomatics, EVKLN, Oberhausen, Germany (GRID:grid.6190.e)
14 Movement Disorders and Neuromodulation Unit, Department for Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany (GRID:grid.6190.e)