39 Body weight changes after deep brain stimulation for obsessive compulsive disorder or major mood disorder RESULTS In the stipulated time period, 68 patients underwent DBS for either OCD (n = 43) or MDD (n = 25). Sufficient details for this analysis were available for 46 patients (30 OCD and 16 MDD patients; 29 females and 17 males, mean age 46.2 years, SD 10.9). All patients received DBS treatment with active electrode contacts in the vALIC and there were no patients with active contacts in the nucleus accumbens (NAc). In 22 patients, there was no reliable recording of a postoperative measurement of body weight. The average baseline BMI in our sample of 46 patients was 28.0 (SD 7.3), with 26 (57%) being overweight (BMI 25–30, n = 11), obese (BMI 30–40, n = 12), or morbidly obese (BMI ≥40, n = 3). There were no significant differences in baseline BMI between males and females or between the diagnostic groups. Follow-up time ranged from 10 months to 8.7 years (mean 3.8 years, SD 2.3). In the OCD group, 17 were classified as responders and 13 as nonresponders, using the criterium of >35% improvement on the Y-BOCS. In the MDD group, 6 were responders and 10 were nonresponders, using the criterium of >50% improvement on the HDRS. Figure 1 shows the individual BMI values at baseline and at the last follow-up (the patient from our earlier published case report is identifiable as the outlier at the bottom right on the graph). There were considerable changes in BMI in one-fifth of the sample; it increased by >5.0 in 3 patients and decreased by >5.0 in 6 patients. The average BMI at the last follow-up was 28.1 (SD 7.0), which was not significantly different from baseline (paired t test, ns). However, a subanalysis showed a two-way interaction for obesity as a small-effect modifier on BMI over time. The average BMI of the 15 patients with (morbid) obesity at baseline decreased slightly from 36.8 to 34.6 (ns), while the average BMI of the 31 normal or “only” overweight patients at baseline increased slightly from 23.8 to 25.0 (ns). There was no significant difference in changes in BMI between the responders and nonresponders to DBS for either OCD or MDD in the open-label evaluations of symptoms. There was also no correlation between changes in body weight and the absolute values of Y-BOCS or HDRS score at baseline or score changes at the time of follow-up.
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