{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:31:38Z","timestamp":1789543898130,"version":"build-2803163510"},"reference-count":70,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1154651"],"award-info":[{"award-number":["GNT1154651"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Deep brain stimulation (DBS) is a safe and effective treatment option for people with refractory obsessive\u2010compulsive disorder (OCD). Yet our understanding of predictors of response and prognostic factors remains rudimentary, and long\u2010term comprehensive follow\u2010ups are lacking. We aim to investigate the efficacy of DBS therapy for OCD patients, and predictors of clinical response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eight OCD participants underwent DBS stimulation of the nucleus accumbens (NAc) in an open\u2010label longitudinal trial, duration of follow\u2010up varied between 9 months and 7\u2009years. Post\u2010operative care involved comprehensive fine tuning of stimulation parameters and adjunct multidisciplinary therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six participants achieved clinical response (35% improvement in obsessions and compulsions on the Yale Brown Obsessive Compulsive Scale (YBOCS)) within 6\u20139\u2009weeks, response was maintained at last follow up. On average, the YBOCS improved by 45% at last follow up. Mixed linear modeling elucidated directionality of symptom changes: insight into symptoms strongly predicted (<jats:italic>P<\/jats:italic>\u2009=\u20090.008) changes in symptom severity during DBS therapy, likely driven by initial changes in depression and anxiety. Precise localization of DBS leads demonstrated that responders most often had their leads (and active contacts) placed dorsal compared to non\u2010responders, relative to the Nac.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The clinical efficacy of DBS for OCD is demonstrated, and mediators of changes in symptoms are proposed. The symptom improvements within this cohort should be seen within the context of the adjunct psychological and biopsychosocial care that implemented a shared decision\u2010making approach, with flexible iterative DBS programming. Further research should explore the utility of insight as a clinical correlate of response. 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