Adaptive DBS for Obsessive-Compulsive Disorder

Not currently recruiting at 2 trial locations
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Baylor College of Medicine
Must be taking: SSRIs, Antipsychotics
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method of using deep brain stimulation (DBS) to assist individuals with severe Obsessive-Compulsive Disorder (OCD) who have not found relief from other treatments. DBS involves placing a device in the brain that sends electrical signals to manage OCD symptoms. The goal is to develop a system that automatically adjusts these signals based on brain activity, aiming to improve symptom control and reduce side effects. Ideal participants are those who have struggled with OCD for at least five years without relief from medications or therapy. As an unphased trial, this study offers participants the chance to contribute to pioneering research that could lead to innovative OCD treatment options.

Will I have to stop taking my current medications?

The trial requires that participants have a stable psychotropic medication regimen for the month before surgery, so you may need to continue your current medications if they are stable. The protocol does not specify stopping any medications.

What prior data suggests that this adaptive DBS system is safe for treating OCD?

Research has shown that deep brain stimulation (DBS) is a safe treatment for individuals with hard-to-treat obsessive-compulsive disorder (OCD). One study found that DBS was effective and manageable for patients with severe OCD, resulting in positive long-term outcomes. Another study on DBS safety confirmed its safety across various locations, with patients generally coping well. Reports so far indicate that DBS can help without causing major side effects, making it a promising option for those with severe OCD.12345

Why are researchers excited about this trial?

Unlike the standard treatments for obsessive-compulsive disorder (OCD), which often involve medications like SSRIs or cognitive-behavioral therapy, the Activa PC+S DBS implant takes a different approach. This treatment uses deep brain stimulation (DBS), a technique that involves delivering electrical impulses directly to specific areas of the brain. Researchers are excited because DBS offers a targeted method to potentially regulate brain activity and alleviate OCD symptoms more effectively, especially in patients who haven't responded to conventional therapies. Moreover, this adaptive DBS system can be adjusted based on the patient's needs, potentially providing a more personalized and responsive treatment option.

What evidence suggests that this adaptive DBS system is effective for OCD?

Research has shown that deep brain stimulation (DBS) can be a safe and effective treatment for people with severe OCD who haven't improved with other treatments. Studies have found that DBS can greatly reduce OCD symptoms, even in those who have had the disorder for many years. One study found that patients experienced a strong decrease in symptoms over more than six years on average. Another study showed that patients generally tolerated DBS well, with few experiencing serious side effects. Overall, evidence suggests that DBS could help manage OCD symptoms when other methods don't work. In this trial, all participants will receive the Activa PC+S DBS implant for OCD, followed by a one-month blinded discontinuation period to confirm clinical benefit.12567

Who Is on the Research Team?

Wayne Goodman, M.D. | BCM

Wayne K Goodman, MD

Principal Investigator

Baylor College of Medicine

Are You a Good Fit for This Trial?

This trial is for adults aged 21-70 with severe OCD that hasn't improved after trying many treatments, including cognitive-behavioral therapy and various medications. Participants must have a significant history of OCD symptoms causing distress and impairment, not be at high risk of suicide or impulsivity, and cannot have other major neurological conditions or be pregnant.

Inclusion Criteria

My OCD wasn't helped by adding antipsychotics to my treatment.
I am between 21 and 70 years old.
I have had OCD for over 5 years, and treatments haven't worked well for me.
See 11 more

Exclusion Criteria

I only have Essential Tremor and no other neurological conditions or brain injuries.
Non-Implanted Control Subject Exclusion criteria: Contraindications to MRI
OCD DBS Subject Exclusion criteria: Any Neurological/Medical condition that makes the subject, in the opinion of the surgeon, a poor candidate
See 17 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

4 weeks
2 visits (in-person)

Treatment

Subjects undergo a single stage DBS surgery, followed by post-operative evaluations and device programming

8 weeks
Multiple visits (in-person) for surgery and follow-up

Post-surgical Monitoring

Participants return to clinic every 2 weeks for the first 2 months following system activation for assessments and recordings

8 weeks
Bi-weekly visits (in-person)

CBT Augmentation

Participants receive a two-month cognitive behavioral therapy course starting at Month 7

2 months

Double Blinded Discontinuation

One-month blinded discontinuation period to confirm clinical benefit

1 month

Monthly Programming/Classification/Evaluation

Monthly visits for programming and evaluation from Month 10 to 18

9 months
Monthly visits (in-person)

Long-Term Follow-Up

Device remains implanted for subjects doing well clinically, with follow-up management arranged on a case-by-case basis

At least 2 years

What Are the Treatments Tested in This Trial?

Interventions

  • Activa PC+S DBS implant for OCD
Trial Overview The study tests an adaptive Deep Brain Stimulation (aDBS) system in patients with hard-to-treat OCD. It involves surgically placing electrodes in the brain to regulate abnormal activity. The goal is to improve symptom management and reduce side effects by adjusting stimulation based on brain signals.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: One Month Blinded Discontinuation PeriodExperimental Treatment1 Intervention
Group II: Activa PC+S DBS implant for OCDExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Baylor College of Medicine

Lead Sponsor

Trials
1,044
Recruited
6,031,000+

National Institute of Neurological Disorders and Stroke (NINDS)

Collaborator

Trials
1,403
Recruited
655,000+

Brown University

Collaborator

Trials
480
Recruited
724,000+

University of Pittsburgh

Collaborator

Trials
1,820
Recruited
16,360,000+

Medtronic

Industry Sponsor

Trials
627
Recruited
767,000+
Geoff Martha profile image

Geoff Martha

Medtronic

Chief Executive Officer since 2020

Finance degree from Penn State University

Dr. Richard Kuntz profile image

Dr. Richard Kuntz

Medtronic

Chief Medical Officer since 2023

MD, MSc

Carnegie Mellon University

Collaborator

Trials
80
Recruited
540,000+

Published Research Related to This Trial

In a study of 30 patients with severe, treatment-refractory OCD, deep brain stimulation (DBS) showed a 42% reduction in obsessive-compulsive symptoms after 12 months, with a responder rate of 60%.
While all patients experienced adverse events (195 total), most were mild or moderate, and the serious adverse events were primarily transient anxiety and worsening of affective symptoms, suggesting that the benefits of DBS may outweigh the risks in this challenging patient population.
A prospective international multi-center study on safety and efficacy of deep brain stimulation for resistant obsessive-compulsive disorder.Menchón, JM., Real, E., Alonso, P., et al.[2022]
Deep brain stimulation (DBS) significantly reduces symptoms of obsessive-compulsive disorder (OCD) and depression, with mean score improvements of -15.0 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and -13.7 on the weighted depression scale at last follow-up, based on a review of 8 randomized controlled trials and 38 observational studies involving a total of 310 participants.
The study found no significant differences in efficacy between different target sites in the brain (limbic vs. non-limbic), and the overall safety profile showed a low rate of adverse events, with an average of 0.68 adverse events per treated patient.
Efficacy, Effect on Mood Symptoms, and Safety of Deep Brain Stimulation in Refractory Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis.Martinho, FP., Duarte, GS., Couto, FSD.[2020]
Deep brain stimulation (DBS) shows promise as a safe and effective treatment for patients with treatment-resistant obsessive-compulsive disorder (OCD), with average reductions in Yale-Brown Obsessive Compulsive Scale scores ranging from 6.8 to 31 points across small studies.
Approximately 50% of patients respond positively to DBS, and the frequency of adverse events appears to be limited, indicating that it could be a viable option for those who do not respond to traditional therapies.
Current status of deep brain stimulation for obsessive-compulsive disorder: a clinical review of different targets.de Koning, PP., Figee, M., van den Munckhof, P., et al.[2021]

Citations

Clinical outcomes of deep brain stimulation for obsessive‐ ...Deep brain stimulation (DBS) is a safe and effective treatment option for people with refractory obsessive‐compulsive disorder (OCD).
Deep Brain Stimulation for Treatment Resistant Depression ...The goal of this study is to use the Activa Primary Cell + Sensing (PC+S) device to study Latent Field Potential (LFP) in the brains of people with Treatment ...
Long-term comparative effectiveness of deep brain ...Our results confirm the powerful effect of DBS on reducing OCD symptoms after 6.4 ± 3.2 years. The use of DBS in OCD was well tolerated with limited and ...
A randomised, double-blind, sham-controlled trial of deep ...Three-year outcomes in deep brain stimulation for highly resistant obsessive-compulsive disorder. Neuropsychopharmacology 31, 2384–2393 ...
Deep Brain Stimulation for Obsessive–Compulsive DisorderOur study supports and builds upon other research suggesting that DBS for OCD in a real-world setting can be implemented successfully and provide long-term ...
A prospective international multi-center study on safety and ...In a prospective, open-label, interventional multi-center study, we examined the safety and efficacy of electrical stimulation in 30 patients with DBS ...
Long-term Outcome of Deep Brain Stimulation of the ...Our results provide evidence that DBS of the ventral part of the anterior limb of the internal capsule is effective and tolerable for treatment-refractory OCD ...
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