WHEN DBS IS RECOMMENDED
When a doctor recommends DBS therapy for obsessive compulsive disorder, the patient should have access to the support and expertise of a psychiatrist, neurologist, and neurosurgeon.
1. EVALUATION BY THE DOCTOR
A psychiatric will evaluate the patient to determine if the patient is a candidate for DBS.
A patient is eligible for DBS Therapy if they:
- Have a diagnosis of OCD with a documented duration of at least 5 years
- Have OCD rated as severe or extreme illness
- Have depression and anxiety
- Have failed to improve following treatment with at least three selective serotonin reuptake inhibitors (SSRIs)
- Are 18 years old or older
The doctor will share the results with the patient, and together they'll decide whether to go forward with the therapy.
Learn more about the criteria for deep brain stimulation therapy for OCD to determine whether the patient may be a suitable candidate.
2. PLANNING — PREPARING FOR SURGERY
The doctor will create images and maps of the brain to help guide the placement of leads during the surgery. An MRI or CT scan will be conducted to capture images of the brain.
3. SURGERY — PLACING THE SYSTEM
There are two parts to the DBS surgery: implanting very thin wires (leads) in the brain and placing the pacemaker-like device, called the neurostimulator, under the skin of the chest. The two parts may be done on the same day, or two different days.
4. PROGRAMMING — STIMULATION SETTINGS
A few weeks later, the doctor will turn on the neurostimulator and adjust the stimulation to best control the symptoms while minimising side effects.
- It will take a few programming sessions to find the stimulation levels that work best.
- There will be follow-up visits to check the results and adjust as needed. These appointments are key to getting the results wanted over time.
5. CONTINUOUS THERAPY
Over time, the doctor will adjust the therapy settings in the device to meet the specific needs. Individualised therapy settings are programmed in the clinic using wireless communication between the implanted device and a clinician programmer. Every individual is different, so programming optimisation may take place over several months to find the settings that best reduce your seizures and potential side effects.
Always follow the doctor's guidance about which activities are okay and which to avoid.
6. CHECKUPS — ONGOING CARE
It's extremely important to attend all checkups with the doctor who manages the DBS therapy. The doctor will:
- Make sure that the DBS system is working properly
- Adjust the stimulation to best control your symptoms
- Check the battery of the neurostimulator to see if a device replacement will be needed soon