Rapid mechanisms of DBS in OCD

Deep brain stimulation (DBS) for therapy-refractory obsessive-compulsive disorder (OCD) patients is capable of improving psychiatric symptoms within seconds to minutes following stimulation initiation. This extraordinary response enticed my interest in exploring the underlying mechanism of DBS for OCD. The main aim of this thesis was to investigate the rapidity of the DBS response as well as various potential working mechanisms. We used clinician rated questionnaires and visual analogue scoring for assessing clinical symptom response, peripheral plasma and urine measures to investigate involvement of the hypothalamic-pituitary-adrenal (HPA)-axis, other neuroendocrine mechanisms and the immune system, and nuclear imaging (SPECT) for investigating striatal dopamine. As our aim was to generate hypothesis we focused on characterizing and possibly linking of the different pathways with each other in connection with clinical symptoms and the cortical-striatal circuit.