TY - JOUR
T1 - Deep brain stimulation response in obsessive–compulsive disorder is associated with preoperative nucleus accumbens volume
AU - Liebrand, Luka C.
AU - Zhutovsky, Paul
AU - Tolmeijer, Eva K.
AU - Graat, Ilse
AU - Vulink, Nienke
AU - de Koning, Pelle
AU - Figee, Martijn
AU - Schuurman, P. Richard
AU - van den Munckhof, Pepijn
AU - Caan, Matthan W.A.
AU - Denys, Damiaan
AU - van Wingen, Guido A.
N1 - Funding Information:
This study was supported by Netherlands Organization for Scientific Research (NWO/ZonMW Vidi 016.156.318), and an Innovation Impulse grant (#2015.011) from the Academic Medical Center.
Publisher Copyright:
© 2021 The Authors
PY - 2021/1
Y1 - 2021/1
N2 - Background: Deep brain stimulation (DBS) is a new treatment option for patients with therapy-resistant obsessive–compulsive disorder (OCD). Approximately 60% of patients benefit from DBS, which might be improved if a biomarker could identify patients who are likely to respond. Therefore, we evaluated the use of preoperative structural magnetic resonance imaging (MRI) in predicting treatment outcome for OCD patients on the group- and individual-level. Methods: In this retrospective study, we analyzed preoperative MRI data of a large cohort of patients who received DBS for OCD (n = 57). We used voxel-based morphometry to investigate whether grey matter (GM) or white matter (WM) volume surrounding the DBS electrode (nucleus accumbens (NAc), anterior thalamic radiation), and whole-brain GM/WM volume were associated with OCD severity and response status at 12-month follow-up. In addition, we performed machine learning analyses to predict treatment outcome at an individual-level and evaluated its performance using cross-validation. Results: Larger preoperative left NAc volume was associated with lower OCD severity at 12-month follow-up (pFWE < 0.05). None of the individual-level regression/classification analyses exceeded chance-level performance. Conclusions: These results provide evidence that patients with larger NAc volumes show a better response to DBS, indicating that DBS success is partly determined by individual differences in brain anatomy. However, the results also indicate that structural MRI data alone does not provide sufficient information to guide clinical decision making at an individual level yet.
AB - Background: Deep brain stimulation (DBS) is a new treatment option for patients with therapy-resistant obsessive–compulsive disorder (OCD). Approximately 60% of patients benefit from DBS, which might be improved if a biomarker could identify patients who are likely to respond. Therefore, we evaluated the use of preoperative structural magnetic resonance imaging (MRI) in predicting treatment outcome for OCD patients on the group- and individual-level. Methods: In this retrospective study, we analyzed preoperative MRI data of a large cohort of patients who received DBS for OCD (n = 57). We used voxel-based morphometry to investigate whether grey matter (GM) or white matter (WM) volume surrounding the DBS electrode (nucleus accumbens (NAc), anterior thalamic radiation), and whole-brain GM/WM volume were associated with OCD severity and response status at 12-month follow-up. In addition, we performed machine learning analyses to predict treatment outcome at an individual-level and evaluated its performance using cross-validation. Results: Larger preoperative left NAc volume was associated with lower OCD severity at 12-month follow-up (pFWE < 0.05). None of the individual-level regression/classification analyses exceeded chance-level performance. Conclusions: These results provide evidence that patients with larger NAc volumes show a better response to DBS, indicating that DBS success is partly determined by individual differences in brain anatomy. However, the results also indicate that structural MRI data alone does not provide sufficient information to guide clinical decision making at an individual level yet.
KW - Anterior limb of the internal capsule
KW - Deep brain stimulation
KW - Machine learning
KW - Nucleus accumbens
KW - Obsessive–compulsive disorder
KW - Treatment outcome prediction
UR - http://www.scopus.com/inward/record.url?scp=85104964882&partnerID=8YFLogxK
U2 - 10.1016/j.nicl.2021.102640
DO - 10.1016/j.nicl.2021.102640
M3 - Article
C2 - 33799272
AN - SCOPUS:85104964882
SN - 2213-1582
VL - 30
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
M1 - 102640
ER -