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Cognitive-behavioural therapy augments the effects of deep brain stimulation in obsessive-compulsive disorder
Abstract
BACKGROUND: Deep brain stimulation (DBS) is a promising new treatment for patients with treatment-refractory obsessive-compulsive disorder (OCD). However, since most DBS patients only show a partial response, the treatment still needs to be improved. In this study we hypothesized that cognitive-behavioural therapy (CBT) could optimize the post-operative management in DBS and we evaluated the efficacy of CBT as augmentation to DBS targeted at the nucleus accumbens. METHOD: A total of 16 patients with treatment-refractory OCD were treated with DBS targeted at the nucleus accumbens. After stabilization of decline in OCD symptoms, a standardized 24-week CBT treatment programme was added to DBS in an open-phase trial of 8 months. Changes in obsessive-compulsive, anxiety and depressive symptoms were evaluated using the Yale-Brown Obsessive Compulsive Scale, Hamilton Anxiety Scale and Hamilton Rating Scale for Depression. RESULTS: Following the addition of CBT to DBS, a significant decrease in obsessive-compulsive symptoms was observed, but not in anxiety and depressive symptoms. In a subsequent double-blind phase, in which stimulation was discontinued, OCD symptoms returned to baseline (relapse) and anxiety and depressive symptoms worsened (rebound) compared with baseline. CONCLUSIONS: The results of this explorative study suggest that a combined treatment of accumbens DBS and CBT may be optimal for improving obsessive-compulsive symptoms in treatment-refractory OCD. However, a subsequent randomized controlled trial is necessary to draw firm conclusions. It seems that DBS results in affective changes that may be required to enable response prevention in CBT. This may indicate that DBS and CBT act as two complementary treatments.
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“a recent study demonstrated that combining DBS with CBT (which included ERP) resulted in a reduction of OCD symptoms in a treatment-refractory sample.[70]”
From Exposure and response prevention for obsessive-compulsive disorder: A review and new directions (2019) · cites this paper as [70]
In the citing paper
“Rehabilitation and behavioral therapy have been shown to have an additive effect for patients receiving DBS for OCD [113].”
From Deep brain stimulation for depression. (2022) · cites this paper as [113]
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Val‐Laillet, D., Aarts, E., Weber, B., Ferrari, M., Quaresima, V., Stoeckel, L. E., Alonso‐Alonso, M., Audette, M. A., Malbert, C., & Stice, E. M. (2015) · NeuroImage Clinical · doi:10.1016/j.nicl.2015.03.016 · Cited by 466
“Even though it has never been tested in our knowledge, the ef fi cacy of targeting speci fi c nuclei for DBS might be validated through its ability to improve real-time brain and cognitive processes related to self-control over highly palatable food stimuli (Mantione et al., 2014).”
Brain circuitry of compulsivity
van den Heuvel, O. A., van Wingen, G., Soriano-Mas, C., Alonso, P., Chamberlain, S. R., Nakamae, T., Denys, D., Goudriaan, A. E., & Veltman, D. J. (2016) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2015.12.005 · Cited by 374
“Also for DBS rules that optimal treatment effects are achieved in case of adjuvant CBT (Mantione et al. 2014).”
Self-citationBergfeld, I. O., Mantione, M., Hoogendoorn, M. L. C., Ruhé, H. G., Notten, P., van Laarhoven, J., Visser, I., Figee, M., de Kwaasteniet, B. P., Horst, F., et al. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.0152 · Cited by 336
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“With regard to the later stage of treatment, our findings testify of the importance of including CBT or another form of psychotherapy within DBS treatment, as has been argued before [58].”
de Haan, S., Rietveld, E., Stokhof, M., & Denys, D. A. J. P. (2017) · PLoS ONE · doi:10.1371/journal.pone.0175748 · Cited by 147
“This is not to say that DBS alone does not already have an impact, see for instance the double blind on-off study [25], but it seems to be the combination with CBT that makes it all the more effective [26, 33].”
BackgroundExposure and response prevention for obsessive-compulsive disorder: A review and new directions
Simpson, H., & Hezel, D. (2019) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_516_18 · Cited by 161
“Moreover, a recent study demonstrated that combining DBS with CBT (which included ERP) resulted in a reduction of OCD symptoms in a treatment-refractory sample.[70] Indeed, DBS has been shown to enhance fear extinction,[71,72] thus highlighting its potential usefulness when paired with a treatment such as ERP.”
BackgroundEfficacy of invasive and non-invasive brain modulation interventions for addiction
Luigjes, J., Segrave, R., de Joode, N., Figee, M., & Denys, D. (2019) · Neuropsychology Review · doi:10.1007/s11065-018-9393-5 · Cited by 125
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The application of deep brain stimulation in the treatment of psychiatric disorders
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“Since we know from prior work that symptoms reduce further after CBT [13,14], we opted to evaluate treatment outcome when stimulation settings were stable and (the majority of) patients had received a least one course of CBT of approximately 24 weeks.”
InfluentialSelf-citationToward personalized medicine in connectomic deep brain stimulation
Hollunder, B., Rajamani, N., Siddiqi, S., Finke, C., Kühn, A. A., Mayberg, H. S., Fox, M., Neudorfer, C., & Horn, A. (2021) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2021.102211 · Cited by 89
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Optimizing Deep Brain Stimulation Parameters in Obsessive–Compulsive Disorder
van Westen, M., Rietveld, E., Bergfeld, I. O., de Koning, P. P., Vullink, N., Ooms, P., Graat, I., Liebrand, L. C., van den Munckhof, P., Schuurman, R., et al. (2020) · Neuromodulation Technology at the Neural Interface · doi:10.1111/ner.13243 · Cited by 64
“In our first 16 patients, the addition of 24 CBT sessions resulted in an additional 22% YBOCS reduction on top of the 25% YBOCS reduction that had been achieved by means of DBS stimulation parameter optimization (51).”
BackgroundClinical outcome and mechanisms of deep brain stimulation for obsessive-compulsive disorder
van Westen, M., Rietveld, E., Figee, M., & Denys, D. (2015) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-015-0036-3 · Cited by 60
Self-citationRodríguez-Romaguera, J., Greenberg, B. D., Rasmussen, S. A., & Quirk, G. J. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2016.02.012 · Cited by 51
“DBS of VC/VS reduces OCD and anxiety symptoms (6) and facilitates patients’ response to ERP therapy (7,8).”
BackgroundInfluentialMartínez-Rivera, F. J., Rodríguez-Romaguera, J., Lloret-Torres, M. E., Monte, F. H. D., Quirk, G. J., & Barreto-Estrada, J. L. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2016.05.015 · Cited by 56
Therapeutic Neurostimulation in Obsessive-Compulsive and Related Disorders: A Systematic Review
Acevedo, N., Bosanac, P., Pikoos, T. D., Rossell, S. L., & Castle, D. J. (2021) · Brain Sciences · doi:10.3390/brainsci11070948 · Cited by 56
“RCTs led to 13% and 51% symptom improvement [161,166], and long-term treatment (6–12 months) led to 12–33% improvement [161,162,168].”
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Davidson, B., Giacobbe, P., George, T. P., Nestor, S. M., Rabin, J. S., Goubran, M., Nyman, A. J., Baskaran, A., Meng, Y., Pople, C. B., et al. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01677-6 · Cited by 52
Deep brain stimulation modulates directional limbic connectivity in obsessive-compulsive disorder
Fridgeirsson, E. A., Figee, M., Luigjes, J., van den Munckhof, P., Schuurman, P. R., van Wingen, G., & Denys, D. (2020) · Brain · doi:10.1093/brain/awaa100 · Cited by 51
“Patients initially experience rapid improvements of mood and anxiety, followed by more gradual decrease of obsessions and compulsion, which may take several weeks and often require additional behavioural therapy for several months (Denys et al., 2010; Mantione et al., 2014).”
BackgroundSelf-citationClosing the loop in psychiatric deep brain stimulation: physiology, psychometrics, and plasticity
Widge, A. S. (2023) · Neuropsychopharmacology · doi:10.1038/s41386-023-01643-y · Cited by 46
“For instance, patients who respond to DBS for OCD describe a subjective improvement in their ability to focus their thoughts and behaviors away from their OCD-driven patterns [116], and objectively gain more bene fi t from exposure/response prevention CBT [117, 118].”
BackgroundInvasive and Non-invasive Neurostimulation for OCD
Bergfeld, I. O., Dijkstra, E., Graat, I., de Koning, P. P., van den Boom, B. J. G., Arbab, T., Vulink, N. C. C., Denys, D. A. J. P., Willuhn, I., & Mocking, R. J. T. (2021) · Current topics in behavioral neurosciences · doi:10.1007/7854_2020_206 · Cited by 46
Kahn, L. W., Sutton, B., Winston, H. R., Abosch, A., Thompson, J. A., & Davis, R. A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.568932 · Cited by 42
“It has also been posited that CBT post-operatively may augment the efficacy of DBS; however, this has only been demonstrated preliminarily in an open-phase trial (48).”
BackgroundThe Psychopharmacology of Obsessive-Compulsive Disorder: A Preclinical Roadmap
Szechtman, H., Harvey, B. H., Woody, E. Z., & Hoffman, K. L. (2019) · Pharmacological Reviews · doi:10.1124/pr.119.017772 · Cited by 41
“Obsessive-Compulsive Disorder as the Dysfunction of a Normal Motivational System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 ABBREVIATIONS: 5-HT, serotonin; AC, adenylate cyclase; ACC, anterior cingulat…”
BackgroundInfluentialWidge, A. S., Zhang, F., Gosai, A. K., Papadimitrou, G., Wilson-Braun, P., Tsintou, M., Palanivelu, S., Noecker, A. M., McIntyre, C. C., O’Donnell, L. J., et al. (2021) · Neuropsychopharmacology · doi:10.1038/s41386-021-01199-9 · Cited by 34
“, the quality of concomitant therapy [26, 64] or general clinical expertise [65], those factors will likely be strongly correlated with the programming clinician, and thus will spuriously load onto the tracts and implant locations that clinician happens to prefer.”
BackgroundDeep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives
Tastevin, M., Spatola, G., Régis, J. M., Lançon, C., & Richieri, R. M. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s178207 · Cited by 36
“Indeed, in the Dutch trial, after stabilization of decline in OCD symptoms, a standardized CBT was added to DBS in an open-phase trial.(85) Interestingly, these patients who initially did not respond to CBT before DBS implantation became sensitive to CBT.”
MethodDeep Brain Stimulation for Treatment-Refractory Mood and Obsessive-Compulsive Disorders
Widge, A. S., & Dougherty, D. D. (2015) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-015-0049-y · Cited by 32
Deep Brain Stimulation for Intractable Obsessive-Compulsive Disorder: Progress and Opportunities
Goodman, W. K., Storch, E. A., Cohn, J. F., & Sheth, S. A. (2020) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.20010037 · Cited by 33
“The first 16 patients received weekly sessions for 24 weeks during open-label DBS (26).”
BackgroundInfluentialDeep brain stimulation in obsessive-compulsive disorder: Results from meta-analysis
Cruz, S., Gutiérrez-Rojas, L., González-Domenech, P., Díaz-Atienza, F., Martínez-Ortega, J. M., & Jiménez‐Fernández, S. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114869 · Cited by 30
Ablative neurosurgery and deep brain stimulation for obsessive-compulsive disorder
Arumugham, S. S., Balachander, S., & Srinivas, D. (2019) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_523_18 · Cited by 31
“patient recovers postsurgically and gets acclimatized to the device after adequate stimulus programming.[36] However,”
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“Huff et al. [24] described two patients out of ten with NAcc DBS to have hypomania episodes that last several days, and Greenberg et al. [12] described one episode of problematic hypomania and one episode of true mania out of 26 patients.”
BackgroundResultInfluentialProgress and challenges in deep brain stimulation for obsessive-compulsive disorder
Kohl, S., & Baldermann, J. C. (2018) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2018.01.011 · Cited by 25
Deep brain stimulation: new possibilities for the treatment of mental disorders
Beszłej, J. A., Wieczorek, T., Kobyłko, A., Piotrowski, P., Siwicki, D., Weiser, A., Fila-Witecka, K., Rymaszewska, J., & Tabakow, P. (2019) · Psychiatria Polska · doi:10.12740/pp/onlinefirst/103090 · Cited by 25
“Although most patients are unable to undergo CBT before DBS treatment, or it is unsuccessful, many patients report that during stimulation they manage to engage in CBT tasks, and they present even greater reduction in OCD symptoms [20, 21].”
Treating OCD: what to do when first-line therapies fail
Castle, D. J., Bosanac, P., & Rossell, S. L. (2015) · Australasian Psychiatry · doi:10.1177/1039856215590027 · Cited by 23
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Hitti, F. L., Widge, A. S., Riva‐Posse, P., Malone, D. A., Okun, M. S., Shanechi, M. M., Foote, K. D., Lisanby, S. H., Ankudowich, E., Chivukula, S., et al. (2023) · Brain stimulation · doi:10.1016/j.brs.2023.05.011 · Cited by 21
“Furthermore, increased interdisciplinary collaboration between psychiatry and psychology was considered essential and integration of psychotherapy in conjunction with neuromodulation could be important in the future.(66,67)”
BackgroundTelemedical Deep Brain Stimulation: Merits and Limitations
Zhang, C., Zhang, Y., Zhan, S., Li, D., Jin, H., Denys, D. A. J. P., & Sun, B. (2018) · Stereotactic and Functional Neurosurgery · doi:10.1159/000491603 · Cited by 21
Recent advances in deep brain stimulation in psychiatric disorders
Clair, A.-H., Haynes, W. I. A., & Mallet, L. (2018) · F1000Research · doi:10.12688/f1000research.14187.1 · Cited by 21
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Management of obsessive-compulsive disorder comorbid with bipolar disorder
Kazhungil, F., & Mohandas, E. (2016) · Indian Journal of Psychiatry · doi:10.4103/0019-5545.192001 · Cited by 17
“[129] Deep brain stimulation (DBS) is still an experimental treatment for OCD.[130] A case of BD-OCD whose OCD symptoms improved, but manic symptoms worsened with DBS of bilateral anterior limbs of the internal capsules is reported.”
BackgroundTreatment Resistance in Obsessive-Compulsive Disorder
Middleton, R., Wheaton, M. G., Kayser, R., & Simpson, H. B. (2019) · Treatment Resistance in Psychiatry · doi:10.1007/978-981-10-4358-1_11 · Cited by 19
Tyagi, H., Apergis-Schoute, A. M., Akram, H., Foltynie, T., Limousin, P. D., Drummond, L. M., Fineberg, N. A., Matthews, K., Jahanshahi, M., Robbins, T. W., et al. (2022) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20105 · Cited by 16
“We anticipated that a positive response to DBS would enable patients to utilize CBT and boost the OCD effect further (38), but this was not found.”
Liebrand, L. C., Zhutovsky, P., Tolmeijer, E., Graat, I., Vulink, N. C. C., de Koning, P. P., Figee, M., Schuurman, P. R., van den Munckhof, P., Caan, M. W. A., et al. (2021) · NeuroImage Clinical · doi:10.1016/j.nicl.2021.102640 · Cited by 18
“In our experience, the treatment effect in DBS for OCD is achieved by an initial anxiolytic effect that is further augmented by exposure-based CBT (Denys et al., 2010; Mantione et al., 2014).”
BackgroundIndian guidelines on neurosurgical interventions in psychiatric disorders
Doshi, P. K., Arumugham, S. S., Bhide, A. V., Vaishya, S., Desai, A., Singh, O. P., Math, S. B., Gautam, S., Rao, T. S. S., Mohandas, E., et al. (2019) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_536_18 · Cited by 15
“It has also been reported that the addition of CBT may augment the effect of DBS even in people who have been refractory to CBT in the past.[19]”
InfluentialThomson, C. J., Segrave, R. A., Fitzgerald, P. B., Richardson, K. E., Racine, É., & Carter, A. (2023) · PLoS ONE · doi:10.1371/journal.pone.0284160 · Cited by 14
“In OCD samples, cognitive behavioural therapy (CBT) has been shown to augment DBS treatment effects [45] and is recommended for best-practice post-operative care [46].”
BackgroundAcevedo, N., Rossell, S. L., Castle, D. J., Groves, C., Cook, M. J., McNeill, P. M., Olver, J. S., Meyer, D., Perera, T., & Bosanac, P. (2023) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13619 · Cited by 14
“In previous studies, long-term DBS stimulation of the NAc has led to 12 – 33% improvement in OCD symptoms, and response in 10 – 56%, 21,45 – 53 yet other targets (ventral anterior limb of the internal capsule (ALIC), ventral capsule/ventral striatum (VC/VS)) have been associated with up to 80%…”
BackgroundWebler, R. D., Oathes, D. J., van Rooij, S. J. H., Gewirtz, J. C., Nahas, Z. H., Lissek, S. M., & Widge, A. S. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.105005 · Cited by 14
Snoek, A., de Haan, S., Schermer, M., & Horstkötter, D. (2019) · Neuroethics · doi:10.1007/s12152-019-09411-w · Cited by 13
Effective Deep Brain Stimulation for Obsessive-Compulsive Disorder Requires Clinical Expertise
van Westen, M., Rietveld, E., & Denys, D. A. J. P. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02294 · Cited by 13
Görmezoğlu, M., van der Vlis, T. A. M. B., Schruers, K. R. J., Ackermans, L. P. C. M., Polosan, M., & Leentjens, A. F. G. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9082383 · Cited by 13
“started CBT after partial response, defined as a substantial reduction of on average 6 points on the Y-BOCS, without further decrease during three consecutive visits [13,14].”
BackgroundMethodInfluentialAcevedo, N., Castle, D. J., Groves, C., Bosanac, P., Mosley, P. E., & Rossell, S. L. (2022) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674221100947 · Cited by 12
Deep brain stimulation in obsessive-compulsive disorder – case report of two patients
Beszłej, J. A., Siwicki, D., Fila-Witecka, K., Wieczorek, T., Piotrowski, P., Weiser, A., Tabakow, P., & Rymaszewska, J. (2019) · Psychiatria Polska · doi:10.12740/pp/104643 · Cited by 12
“Following the assumption of researchers that CBT reduces compulsive symptoms with an adequate (allowing exposure) level of anxiety [9], in future cases it would be necessary to check whether the subsequent introduction of CBT (after further improvement of symptoms, especially in terms of anxiety…”
InfluentialDeep brain stimulation and treatment-resistant obsessive-compulsive disorder: A systematic review
Vázquez-Bourgón, J., Martino, J., Peña, M. S., Infante, J., Martínez, M. Á. M., Ocón, R., Menchón, J. M., Crespo‐Facorro, B., & Vázquez-Barquero, A. (2019) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2017.05.015 · Cited by 11
Vázquez-Bourgón, J., Martino, J., Peña, M. S., Infante, J., Martínez, M. Á. M., Ocón, R., Menchón, J. M., Crespo‐Facorro, B., & Vázquez-Barquero, A. (2017) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2017.05.005 · Cited by 11
Kilian, H. M., Schiller, B., Meyer, D. M., Heinrichs, M., & Schläpfer, T. E. (2024) · Translational Psychiatry · doi:10.1038/s41398-023-02712-y · Cited by 9
Abdulbaki, A., Masri, J. E., Ghazi, M., Kahl, K. G., Mocking, R. J. T., Salameh, P., Schuurman, R., Nuttin, B., & Krauss, J. K. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116651 · Cited by 8
Deep Brain Stimulation for Depression
Bergfeld, I. O., & Figee, M. (2020) · Springer eBooks · doi:10.1007/978-3-030-36346-8_18 · Cited by 8
Graat, I., Franken, S., van Rooijen, G., de Koning, P. P., Vulink, N. C. C., de Kroo, M., Denys, D. A. J. P., & Mocking, R. J. T. (2022) · Psychological Medicine · doi:10.1017/s0033291722003130 · Cited by 6
“Previously, our group explored the effects of CBT in a group of 16 patients with vALIC DBS for OCD (Mantione et al., 2014).”
BackgroundResultInfluentialA Synergistic Treatment Strategy for Severe Obsessive Compulsive Disorder
Kohl, S., Baldermann, J. C., Denys, D. A. J. P., & Kuhn, J. (2016) · Neuromodulation Technology at the Neural Interface · doi:10.1111/ner.12461 · Cited by 6
“Our data underlines our hypothesis that patients experiencing a clinical improvement under DBS of the NAcc may profit from renewed CBT, although earlier CBT trials did not lead to an improvement (24).”
ResultArumugham, S. S., Srinivas, D., Narayanaswamy, J. C., Jaisoorya, T. S., Kashyap, H., Domenech, P., Palfi, S., Mallet, L., Venkatasubramanian, G., & Reddy, Y. C. J. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-047492 · Cited by 7
van Westen, M., Rietveld, E., van Hout, A., & Denys, D. A. J. P. (2021) · Phenomenology and the Cognitive Sciences · doi:10.1007/s11097-021-09732-3 · Cited by 6
Acevedo, N., Castle, D. J., & Rossell, S. L. (2024) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2024.2306875 · Cited by 5
“This notion is supported by changes in activation in motivational and affective regions from DBS [117] and cognitive control regions from CBT [118], as well as improved cognition from DBS [119] and synergistic effects of DBS and CBT [71,80].”
BackgroundSugiyama, K., Nozaki, T., Asakawa, T., Sameshima, T., KOIZUMI, S., Hiramatsu, H., & Namba, H. (2018) · Neurologia medico-chirurgica · doi:10.2176/nmc.st.2018-0115 · Cited by 5
Fanty, L., Yu, J., Chen, N., Fletcher, D. B., Hey, G. E., Okun, M. S., & Wong, J. K. (2023) · Expert Review of Medical Devices · doi:10.1080/17434440.2023.2252732 · Cited by 5
“By targeting multiple points within an aberrant circuit through CBT and DBS, patients can achieve significantly improved therapeutic benefit [63,75].”
BackgroundPsychiatric neuromodulation: the underappreciated importance of pre- and post-treatment care
Davidson, B., Li, D. Z., Meng, Y., Hamani, C., & Lipsman, N. (2020) · Molecular Psychiatry · doi:10.1038/s41380-020-0851-0 · Cited by 5
Sheth, S. A., Provenza, N. R., Soubra, S. S., Hamre, T. A., Shofty, B., Banks, G. P., Giridharan, N., Momin, F., Vogt, G. S., McKay, S. A., et al. (2026) · medRxiv · doi:10.64898/2026.04.24.26351318 · Cited by 5
Deep brain stimulation in Gilles de la Tourette syndrome: killing several birds with one stone?
Hartmann, A. (2016) · F1000Research · doi:10.12688/f1000research.9521.1 · Cited by 4
“An example from the OCD world concerns patients who underwent a 24 week CBT treatment programme after DBS of the nucleus accumbens (Mantione et al., 2014).”
BackgroundBaldi, S., Vandenberk, E., Bors, J., Goossens, L., Cort, K. D., Ackermans, L. P. C. M., Leentjens, A. F. G., Linden, D. E. J., Duits, A., Temel, Y., et al. (2023) · Deep Brain Stimulation · doi:10.1016/j.jdbs.2023.12.003 · Cited by 4
Glannon, W. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780198758853.003.0009 · Cited by 4
Zrinzo, L. U. (2024) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s407210 · Cited by 3
“62 A multidisciplinary approach, involving both psychiatrist and neurosurgeon, is essential during patient selection, perioperative care, and lifelong follow-up.”
BackgroundDeep brain stimulation – A primer for psychiatrists
Sharma, L. P., Ganesh, U. M., Arumugham, S. S., Srinivas, D., Venkatasubramanian, G., & Reddy, Y. C. J. (2024) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2024.104354 · Cited by 3
van der Vlis, T. A. M. B., & Duits, A. (2021) · Neuromodulation Technology at the Neural Interface · doi:10.1111/ner.13533 · Cited by 3
From lobotomy to connectomics: a critical review of contemporary psychosurgery
González, V., Rumià, J., Brell, M., Roset, C., de Miguel, J., Arboleya, S., Aguirre, I., Alegre, D., Goliney, V. G., & Ibáñez, J. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1785333 · Cited by 3
“…shown cognitive decline after surgery; on the contrary, some patients — particularly after BNST-DBS — show improved cognitive fl exibility (207), which may open a “ second window ” for psychotherapies and supports framing DBS as an adjunctive component within a multimodal treatment strategy (208).”
Electrical deep neuromodulation in psychiatry
Polosan, M., & Figee, M. (2021) · International review of neurobiology · doi:10.1016/bs.irn.2021.06.007 · Cited by 2
Prefrontal Network Mechanisms of Psychiatric Deep Brain Stimulation
Glewwe, N., Grissom, N. M., & Widge, A. S. (2025) · Journal of Neuroscience · doi:10.1523/jneurosci.1944-24.2025 · Cited by 4
Stereotactic Functional Neurosurgery for Mental Health Disorders, Pain, and Epilepsy
Hyam, J. A., & Zrinzo, L. U. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-43140-8.00058-5 · Cited by 2
An Enactive Approach to Causes, Diagnosis, and Treatment of Psychiatric Disorders
de Haan, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108685214.009 · Cited by 2
Deep Brain Stimulation for Obsessive-Compulsive Disorder—Reply
Hirschtritt, M. E., Bloch, M. H., & Mathews, C. A. (2017) · JAMA · doi:10.1001/jama.2017.7873 · Cited by 2
Pereira de Souza, A. M. F. L., Mpavaenda, D., Banca, P., Wellsted, D., Hopkins, J., Marzuki, A. A., Lee, M., Karafylli, E., Bardsley, O., Mazoruk, S., et al. (2026) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2026.152666 · Cited by 1
“Some individuals drop out of ERP due to beliefs that the exposures are ‘too difficult ’ to perform [27], or that the anxiety provoked by ERP is ‘too intense ’ to bear [28,29].”
de Haan, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108685214.008 · Cited by 1
Cognitive Behavioral Therapy: state of the art, a review
Maia, A. C. C. D. O., Pereira, L. M. N., Nardi, A. E., & Cardoso, A. (2015) · Medical Express · doi:10.5935/medicalexpress.2015.06.01 · Cited by 1
Tundo, A., Salvati, L., Cieri, L., Balestrini, V., Spigno, D. D., Orazi, F., Iommi, M., & Necci, R. (2022) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2022.2054351 · Cited by 1
“The Y-BOCS reduction in our study (28% at endpoint) is quite similar to that reported in 2 previous studies (22% and 35%, respectively) including patients with a level of OCD treatment resistance comparable with that of our patients and treated with SRI-Deep Brain Stimulation-CBT augmentation (Mantione et al., 2014; T…”
ResultIntervening in the psychopath’s brain
Glannon, W. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780198758853.003.0007 · Cited by 1
Acevedo, N., Castle, D. J., Bosanac, P., & Rossell, S. L. (2023) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674231184410 · Cited by 1
Neurobiology of deep brain stimulation for psychiatric disorders
Gadot, R., Giridharan, N., Rajesh, S. V., Provenza, N. R., Banks, G. P., Storch, E. A., Goodman, W. K., & Sheth, S. A. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-18496-3.00023-9 · Cited by 1
Diepe hersenstimulatie bij obsessieve-compulsieve stoornis: 10 jaar ervaring in het AMC
Bais, M. N., Figee, M., Schuurman, R., & Denys, D. A. J. P. (2015) · Neuropraxis · doi:10.1007/s12474-015-0087-y · Cited by 1
“In 2014 werden de resultaten gepubliceerd van deze gecombineerde behandeling [8].”
BackgroundTreating psychiatric disorders: Less invasive and noninvasive interventions
Glannon, W. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780198758853.003.0004 · Cited by 1
Deep Brain Stimulation for Obsessive-Compulsive Disorder
Kohl, S., & Kuhn, J. (2017) · JAMA · doi:10.1001/jama.2017.7849 · Cited by 2
Lawford‐Smith, H. (2015)
Disorders of consciousness, memory, and will
Glannon, W. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780198758853.003.0003
Euthanasia and assisted suicide for psychiatric disorders
Glannon, W. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780198758853.003.0008
Glannon, W. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780198758853.003.0002
Neuromodulation: Control, identity, and justice
Glannon, W. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780198758853.003.0006
Epilogue: Psychiatry, neuroscience, philosophy
Glannon, W. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780198758853.003.0010
Development of brain stimulation
Crowell, A. L., Riva‐Posse, P., & Mayberg, H. S. (2020) · doi:10.1093/med/9780198713005.003.0019
Metadata
- Authors
- Mantione, M., Nieman, D. H., Figee, M., & Denys, D.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Netherlands Institute for Neuroscience (NL)
- Corresponding author
- Mantione, M.
- Denys, D.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-04-25
- Volume
- 44
- Issue
- 16
- Pages
- 3515-3522
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2105399857
- Cited by
- 129
- References
- 33
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 8 · 2023: 9 · 2022: 10 · 2021: 11 · 2020: 20 · 2019: 15 · 2018: 23 · 2017: 6 · 2016: 6 · 2015: 10
- FWCI
- 8.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, deep brain stimulation, cognitive behavioral therapy, treatment-refractory OCD, nucleus accumbens, augmentation therapy, response prevention, symptom recurrence, anxiety and depressive symptoms
- MeSH terms
- Adult, Combined Modality Therapy, Double-Blind Method, Female, Humans, Male, Middle Aged, Netherlands, Obsessive-Compulsive Disorder, Psychiatric Status Rating Scales, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome, Cross-Over Studies, Deep Brain Stimulation
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