Abstract
Mood disorders like major depressive (MDD) and obsessive compulsive (OCD) disorders affects 300 million people worldwide, and 20–30% are refractory to drug therapy (1). OCD could lead to a lifetime of disabling symptoms while treatment resistant depression (TRD) could lead to suicidal attempts (2, 3). Symptoms common to both disorders include anxiety, sleep disturbances and disruption of selective attention, in contrast to the obsessive thinking and compulsive behavior in OCD, and guilt, concentration problems, sadness and passive behavior in MDD (4).
Deep Brain Stimulation (DBS) has been proposed to treat patient's refractory to drug treatment of these disabling disorders in the same surgical target's network (5). Using probabilistic tractography we visualized that all the proposed targets for the treatment of these disorders have a structural connectivity with the orbitofrontal cortex (OFC), indicating that both pathologies involve dysfunction networks that link OFC with different subcortical and cortical structures (6) (Figure 1). In this report we analyze the physiological, anatomical and biochemical characteristics of the OFC subcortical connections, as well as the mechanisms of DBS, to explain why DBS of the different targets with common structural connectivity may control obsessive-compulsive as well as depressive symptoms, seeking to improve future DBS therapy.