Obsessive-compulsive
disorder (OCD) is a psychiatric disorder affecting approximately 2% of the
population. It is characterized by thoughts that are both equally as obsessive
as they are intrusive, which generate anxiety. Such thoughts are then followed by
compulsions with the function of neutralizing the distress, which is caused by
the intrusive thoughts. OCD is among the most disabling psychiatric disorders,
and there’s a significantly high mortality rate associated with the disorder.
There is also research that indicates 10–27% of the patients may attempt
suicide sometime during their lifetime. (Naesström et al., 2017)
Matilda Naesström and a
team of researchers examine both the basis of knowledge and concerns regarding
deep brain stimulation with respects to treating OCD in, “Deep Brain
Stimulation for Obsessive-Compulsive Disorder: Knowledge and Concerns among
Psychiatrists, Psychotherapists and Patients.” Naesström conducted an online
survey, which was intended to target specific professional groups, i.e.
patients, psychiatrists, and cognitive behavioral therapists. The survey asked
questions that meant to determine the magnitude of prior knowledge in the
treatment method of deep brain stimulation, as well as determining reasons for
concern, if any with respects to the treatment. They found that the primary
source of information for professionals was from scientific sources, i.e.
contemporary research, professional colleagues, etc. Oppositely, patients
indicated that their primary source of information was the media, which itself
is cause for concern given that the media sensationalizes popular psychology.
That aside, the survey found that common areas of concern within both groups
include: surgical complications, side effects--specifically personality changes,
and anesthetic complications.
The paper, “Neuron
matters: electric activation of neuronal tissue is dependent on the interaction
between the neuron and the electric field,” notes that neurons are able to be
activated by using electromagnetic induction methods. The objective of the
research was to explain the transmembrane electric field and its induced
transmembrane potential with respects to external electric stimulation. Dr. Hui Ye explains that in deep brain
stimulation, “alternating currents applied via transcranial alternating current
stimulation (tACS) over the occipital cortex of the brain can entrain neural
oscillations of the underlying brain,” (Ye & Steiger, 2015). It also
details that within lab research, direct current (DC) electric stimulation
indicates suppression of in vitro seizure activity (Ye & Steiger, 2015).
Given such results, it is suspected that deep brain stimulation can be used to
treat other neurological and psychiatric illnesses; however, there’s still
great cause for concern in this method in a variety of areas.
Dr. Ye’s research does
prove to be a significant breakthrough in treating neurological and
psychiatric. However, it becomes imperative for all medical professionals to
understand the perils of generalization in treatment. Although suppression of
seizure activity could be seen, it still become unclear if deep brain
stimulation can be used “across the board” to treat other disorders, of which
are different in how they impair neurological functions. Naesström’s research
indicates the skepticism behind this treatment method specifically with respect
to OCD, as well as demonstrating there is still much to observe about it in
both perspectives of patients and psychiatric/neurological professionals.
Additionally, her research shows how much more professionals need to advocate
for education of specialized treatments, such as deep brain stimulation, in
order to properly clarify what is meant to happen and what could happen as a
result to patients that choose to consider it.
To conclude, challenges
exist for deep brain stimulation in OCD, which was indicated by participants of
Naesström’s research. The challenges being: sources of information, potential
negative side effects, and whether or not patients are eligible. Within those
given criteria, the current evidence foundation still is limited, and a vast
research agenda is still required for research going forward.
References
Ye, H, and A Steiger.
“Neuron Matters: Electric Activation of Neuronal Tissue Is
Dependent on the
Interaction between the Neuron and the Electric Field.” Current
Neurology and
Neuroscience Reports., U.S. National Library
of Medicine, 12 Aug.
2015,
www.ncbi.nlm.nih.gov/pubmed/26265444.
Naesström, Matilda, et
al. “Deep Brain Stimulation for Obsessive-Compulsive Disorder:
Knowledge and Concerns
among Psychiatrists, Psychotherapists and Patients.” National
Center for Biotechnology
Information, US National Library of
Medicine, 6 Dec. 2017,
www.ncbi.nlm.nih.gov/pmc/articles/PMC5735431/.
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