Novel Deep Brain Stimulation in Ventral Capsule and Stratum for Refractory Obsessive-Compulsive Disorder

Inclusion Criteria:

1. Age between 18 and 65 years.

2. A primary diagnosis of OCD, defined according to the criteria of the Diagnostic andStatistical Manual of Mental Disorders, fifth edition (DSM-V).

3. Chronic: at least a 3-year history of OCD symptoms with psychosocial dysfunction

4. Severity: a score on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) of more than 25 or one subscale score of more than 15 ; a score for severity of illness on theClinical Global Impression (CGI) scale of more than 4.

5. Disability: a score on the Global Assessment Functioning (GAF) scale of less than 45or a score on Sheehan Disability Scale more than 24.

6. Refractory: a lack of response to drug therapy after adequate administration, definedas more than two types of serotonin reuptake inhibitors at the maximum tolerated dosefor more than 12 weeks. Adequate behavior therapy, defined as more than 20 sessionspsychotherapy with experienced therapist.

7. OCD medication regimen is stable for at least 4 weeks before enrollment.

Exclusion Criteria:

1. Schizophrenic disorder; bipolar disorder; substance abuse or dependence (except fordependence on nicotine), as assessed with the use of the Mini-InternationalNeuropsychiatric Interview (MINI 6.0.0).

2. Cluster A or B personality disorder according to DSM-IV-TR criteria, as assessed withthe use of the Structured Clinical Interview II.

3. A current severe major depressive episode, determined according to DSM-V criteria (asassessed with the use of the MINI 6.0.0) and defined by the Hamilton Depression RatingScale-17 (HAMD) score of more than 20 and a risk of suicide.

4. Abnormal cognitive status (measured by MoCA), abnormal findings on functional magneticresonance imaging (MRI) of the brain, or contraindications to surgery or anesthesia.