Brain Stimulation Reduces Dopamine & Eases OCD

brain stimulationThe Academic Medical Center of the University of Amsterdam has released new research that suggests that deep brain stimulation (DBS) may help return the increased dopamine levels seen in patients with obsessive-compulsive disorder (OCD) back to normal.[1] Dopamine is a neurotransmitter that brings pleasure when it is released due to rewarding stimuli, such as food, sex, exercise, and drug use.1 For people with OCD, their dopamine levels are constantly increased due to the reward they receive from completing their obsessive-compulsive tasks.1 However, as they become even more compulsive, the related dopamine release becomes deficient in the striatum, or the brain region that is involved in reward and behavior control.1

Therefore, for the study, the researchers recruited clinically stable outpatients with OCD who had been receiving DBS therapy for more than one year.1 Each patient underwent three single photon emission computerized tomography (SPECT) imaging scans that measured the dopamine availability in the brain.1 The researchers were looking to measure the relationship that exists between dopamine and OCD symptoms.1

They discovered that during the chronic DBS phase, patients had increased striatal dopamine release, compared to their healthy counterparts.1 However, when the DBS was turned off, patients showed a worsening of symptoms and reduced dopamine release.1 Therefore, enhancing striatal dopamine signaling may have therapeutic effects for treatment-resistant OCD.1

As decreased central dopamine receptor binding is key in areas of the brain, dopamine is important for reward-motivated behaviors.1 This may be why DBS is able to restore healthy behavior in patients who suffer from OCD.1 The patients who participated had previously been non-responsive to the traditional pharmacological therapies that target the dopamine system, suggesting that the effectiveness of DBS may be due to its ability to compensate for an underlying dysfunction in the dopaminergic system.1 By increasing dopamine, patients are able to control more of the obsessive-compulsive behaviors.1

“It is exciting to see circuit-based DBS linked to molecular brain imaging,” said Dr. John Krystal, editor of Biological Psychiatry. “This is a strategy that may shed light into the mechanisms through which this treatment can produce positive clinical change.”1

Krystal also noted: “It would be interesting to know whether the patients who do not response to dopamine-blocking antipsychotic medications commonly prescribed for OCD symptoms have a different underlying disturbance in dopamine function that the patients enrolled in this study failed to respond to these medications. Nonetheless, the findings of this study raise the possibility that some deficits in dopamine signaling in the brain that might be targeted by novel treatments may prevent adequate response to conventional treatments for this disorder.”1

[1] Nauert, R. (2014). Brain Stimulation May Help Ease OCD Symptoms By Impacting Dopamine. Psych Central. Retrieved on May 1, 2014, from http://psychcentral.com/news/2014/05/01/brain-stimulation-may-help-ease-ocd-symptoms-by-impacting-dopamine/69243.html

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