A patient has become the first person in the world to benefit from an innovative brain implant stimulator that controls two debilitating conditions – epilepsy and obsessive-compulsive disorder (OCD).
Medics have discovered that the use of responsive deep brain stimulation guided by the electrical activity in the ventral striatum can significantly reduce obsessive behaviours and compulsions for long-lasting improvement.
The patient – Amber Pearson, a 34-year-old resident of Albany, Oregon – reported significant improvements in managing her seizures and substantial relief from compulsive behaviours following the life-changing procedure at Oregon Health & Science University (OHSU).
She said: ‘OCD is worse than having the seizures. Epilepsy brings limitations to my life, but OCD controlled it.’
A recent case study published in the journal Neuron detailed the innovative approach.
Collaborating with experts from various institutions in the US, the study showcases the interactive programming of a responsive neurostimulation system (RNS), which seamlessly controls the compulsive behaviours that once dominated Amber’s life.
Describing her past experiences, she said: ‘Before I started treatment with my RNS, I would wash my hands until they would bleed. My hands would be so dry that bending my fingers would crack the skin of my knuckles.’
Additionally, simple tasks such as checking windows and closets or ensuring the stove was off before bed would take up to 45 minutes.
She could not sit next to people while eating out for fear their food would contaminate hers, even during family meals over holidays. She even felt compelled to take a shower every time she changed the cat’s litter box.
In March 2019, Dr Ahmed Raslan, a professor of neurological surgery at the OHSU School of Medicine, implanted the device to control Pearson’s seizures.
The 32mm-long electrode spanned the portion of her brain known as the nucleus accumbens, which is associated with motivation and action, including compulsive urges.
Dr Raslan explained: ‘I could target both portions of the brain and get a second benefit.’
He worked closely with Dr Casey Halpern, a neurosurgeon who conducted the research component of the procedure aimed at treating Amber’s OCD through Stanford University.
Dr Marissa Kellogg, an assistant professor of neurology at OHSU, had met Pearson as a patient in 2016 and was struck by her resilience despite her severe health difficulties. Pearson had previously undergone standard surgery to treat drug-resistant seizures in 2018, which involved removing a small portion of the brain where seizures originated.
While this procedure mitigated some seizures, it did not eliminate them entirely, leading Amber to opt for the implantation of the RNS device.
The RNS implant actively monitors brain activity and delivers a small pulse to quell seizures before they start.
In the course of her research, Amber discovered that some patients had reported that such implants alleviated psychiatric conditions, including OCD.
Dr Kellogg explained: ‘It was an incredible opportunity. Amber is really a future-thinking patient, and she really drove the boat here.’
Dr Kellogg, who specialises in mental health conditions sometimes associated with epilepsy, had done her fellowship training at Stanford and was aware of the strong psychiatry programme there with experience in programming devices for off-label research purposes under the oversight of Stanford’s institutional review board.
The patient noticed relief from her OCD within months of the brain implant in 2019. Four years on, her life has been profoundly transformed, and she now lives independently for the first time in many years.
