Deep brain stimulation for obsessive-compulsive disorder is associated with cortisol changes

Pelle P. de Koning, Martijn Figee, Erik Endert, Jitschak G. Storosum, Eric Fliers, Damiaan Denys

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Deep brain stimulation (DBS) is an effective treatment for obsessive-compulsive disorder (OCD), but its mechanism of action is largely unknown. Since DBS may induce rapid symptomatic changes and the pathophysiology of OCD has been linked to the hypothalamic-pituitary-adrenal (HPA) axis, we set out to study whether DBS affects the HPA axis in OCD patients. We compared a stimulation ON and OFF condition with a one-week interval in 16 therapy-refractory OCD patients, treated with DBS for at least one year, targeted at the nucleus accumbens (NAc). We measured changes in 24-h urinary excretion of free cortisol (UFC), adrenaline and noradrenaline and changes in obsessive-compulsive (Y-BOCS), depressive (HAM-D) and anxiety (HAM-A) symptom scores. Median UFC levels increased with 53% in the OFF condition (from 93 to 143. nmol/24. h, p= 0.12). There were no changes in urinary adrenaline or noradrenaline excretion. The increase in Y-BOCS (39%), and HAM-D (78%) scores correlated strongly with increased UFC levels in the OFF condition. Our findings indicate that symptom changes following DBS for OCD patients are associated with changes in UFC levels.

Original languageEnglish
Pages (from-to)1455-1459
Number of pages5
Issue number8
StatePublished - Aug 2013
Externally publishedYes


  • Adrenaline
  • Cortisol
  • Deep brain stimulation (DBS)
  • Hypothalamic-pituitary-adrenal (HPA) axis
  • Noradrenaline
  • Obsessive-compulsive disorder (OCD)


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