Deep brain stimulation (DBS) involves stimulating certain parts of your brain with implanted electrodes. It’s a promising treatment for treatment-resistant OCD.

The main treatments for OCD are talk therapies, such as cognitive behavior therapy (CBT), and medications. DBS may be an option if these treatments alone aren’t effective. It requires undergoing surgery to implant electrodes in your brain.

OCD is a mental health disorder involving persistent obsessive thoughts and compulsive behavior.

Obsessive thoughts are defined as recurrent and persistent thoughts, urges, or images that are intrusive or unwanted that you try to ignore or suppress with a certain action.

Compulsive behavior is defined as repetitive behavior, such as excessive handwashing, or mental acts, such as counting, that you feel driven to perform in response to an obsession.

Read on to learn more about how DBS is used to treat OCD.

DBS is a procedure that involves implanting electrodes into specific parts of your brain to change your brain activity. The electrodes stimulate these regions with a mild electrical current. The currents reach your brain through wires implanted under your skin near your collarbone.

The Food and Drug Administration (FDA) has approved DBS to treat several conditions, such as:

DBS was first approved in 2009 for treating OCD following evidence that it may resolve symptoms by targeting parts of your brain called the ventral capsule, ventral striatum, or subthalamic nucleus.

Here’s a general idea of what to expect during your DBS procedure. Your exact procedure may vary.

  1. You may receive intravenous (IV) general anesthesia to sedate you. Alternatively, you might receive a local anesthetic to numb the surgical areas and a sedative through an IV to keep you still during your procedure.
  2. A healthcare professional places a headframe over your head and a catheter into your bladder. You’re then taken to the radiology unit to receive a head CT scan.
  3. A healthcare professional cuts the hair around the operative site and disinfects your scalp.
  4. A surgeon removes a flap of skin from your scalp and makes small holes in your skull with a special drill to access your brain.
  5. At this point, your care team may wake you up to help determine the best area to place the electrode. Once your surgeon finds the right spot, they’ll implant the electrode.
  6. The electrode is tested to ensure it’s functioning properly. You’ll likely receive another CT scan to check its location.
  7. Your surgeon closes the operative site and covers the wound with bandages. You’ll likely need to stay in the hospital for at least 1 or 2 days.

Your doctor can tell you about the pros and cons of DBS. If you decide to go ahead with the procedure, you’ll need tests to measure your overall health, such as blood or urine tests. You’ll also likely undergo an MRI so your surgical team can see where to implant the electrodes.

Your surgical team can tell you if you need to stop taking medications before your procedure or when to stop eating. You’ll have the option of shaving your own head instead of having it shaved during your procedure.

You won’t be able to drive after your procedure, so you’ll have to arrange a way home in advance.

DBS is generally only considered for OCD cases that don’t respond to less invasive treatments.

According to a 2024 study, more than 10% of OCD cases are resistant to first-line medications by themselves or with CBT. A 2022 research review suggests that 40% to 60% of cases don’t respond to CBT and multiple trials of medications known as selective serotonin reuptake inhibitors (SSRIs).

DBS has emerged as a treatment option for people with severe and treatment-resistant symptoms. Response rates have been reported as high as 60%.

DBS requires surgery. All types of surgery come with some risk of complications or side effects.

Potential risks of DBS include:

  • not responding to the treatment
  • seizures or the development of epilepsy
  • confusion or changes in behavior, which may last days or weeks
  • stroke
  • infection
  • breakage of the electrode
  • changes in speech, balance, or thinking ability
  • reversible side effects that may go away when the electrode is turned off, such as:
    • slurred speech
    • tingling feeling
    • involuntary movement
  • death (occurs in about 1 in 500 operations)

DBS helps some people with OCD improve their symptoms. It’s not considered a cure, though. If the device is discontinued, it’s likely your symptoms will return.

For people with severe OCD, a reduction in symptoms may lead to a significant increase in quality of life.

In a 2021 review of 40 studies that included at least a 36-month follow-up with individuals who had DBS for OCD, researchers reported:

  • 49.5% of people had a good and sustained long-term response to DBS
  • 22.5% of people had a partial long-term response to DBS (had improved at some point, but experienced relapses during follow-up)
  • 26.6% of people had no improvement from DBS for OCD

Various studies have reported long-term symptom improvements between 20% to 66%, as measured on the Yale-Brown obsessive-compulsive scale. This scale aims to quantify OCD severity.

DBS devices contain either rechargeable or nonchargeable batteries that need to be replaced surgically. Nonchargeable batteries last about 2 to 5 years. Rechargeable batteries usually last 9 years or more.

After your procedure, you will likely need to spend a day or two in the hospital for monitoring. You’ll also need regular follow-ups with a healthcare professional to ensure that your device is working properly.

Insurance providers sometimes cover DBS. However, getting private insurance to cover DBS for OCD is a significant impediment.

A 2021 report from one healthcare center that provides DBS for people with treatment-resistant OCD determined that having non-Medicare insurance is the biggest factor limiting access to DBS for OCD.

DBS is an option for OCD when CBT or medications aren’t effective. It involves implanting an electrode in your brain to stimulate certain regions associated with OCD.

DBS isn’t a cure for OCD, but a significant number of people experience a reduction in their symptoms. Like all surgeries, it comes with some risks. Your healthcare professional can best advise you of these risks.