News in brief: Deep brain stimulation for OCD; CTE prevalent in most AFL players; Dementia deaths down in 2020

22 Apr 2021

DBS sparks hope for people with OCD

A Queensland-led study has found deep brain stimulation (DBS) is effective in severe, treatment-resistant OCD.

The RCT of nine adults compared active and sham stimulation of electrodes in the bed nucleus of the stria terminalis (BNST) posterior to the nucleus accumbens and inferomedial to the ventral pallidum.

The blinded study found a statistically-significant difference in the Yale Brown Obsessive-Compulsive Scale (YBOCS) reduction in favour of active stimulation after three months (p = 0.025, mean difference 4.9 points, 95 % CI = 0.8–8.9).

All patients were then switched on and referred for a course of ERP-based CBT. There was a mean YBOCS reduction of 49.6% and seven participants meeting the threshold for clinically-significant response after 12-months of open-label stimulation.

Serious adverse events reported included deviation of one electrode requiring reimplantation, two patients requiring psychiatric admissions for recurrence of depressive symptoms, and one infection requiring device explantation.

The researchers, including neurologist Professor Peter Silburn, said their findings add to the emerging literature supporting the use of DBS as a therapy in otherwise treatment-resistant OCD.

Translational Psychiatry

Most AFL players have signs of CTE

More than 80% of retired AFL players show signs of impaired neurological functioning that back their self-reported concerns around memory, mood problems and movement disorders, a neuroscientist from Australia’s Sports Brain Bank says.

Professor Alan Pearce of LaTrobe University, Victoria said testing revealed warning signs of Chronic Traumatic Encephalopathy (CTE) were evident in most of the 162 former AFL/VFL football players with a history of concussion.

He said the worrying findings supported a 30 day return-to-play standown period for players affected by concussion. However the AFL’s recently updated concussion guidelines only call for players to be sidelined for 12 days.

Professor Pearce published his findings in Frontiers in Neurology.

Dementia deaths dropped with the pandemic

Despite the stark fact that almost a third (30%) of COVID-19 deaths in Australia from Jan-Oct 2020 were in people with dementia, the pandemic’s impact on a vulnerable and elderly group has been nuanced.

A report from the AIHW has shown most of the people with dementia who died from COVID-19 were women over 85 years of age.

Yet the overall death rate in people with dementia dropped during the 2020 study period compared to earlier years (58 v 63 deaths per 100,000 population).

Similarly, deaths due to other respiratory illnesses also dropped during COVID-19.

“These results suggest that the measures in place to control the virus indirectly reduced dementia mortality rates in Australia during the first 10 months of 2020,…” AIHW spokesperson Dr Fleur de Crespigny said.

“While early evidence suggests that these measures have assisted in reducing deaths due to other respiratory conditions, it is important to note the impacts of social isolation and loneliness on overall wellbeing, particularly among those living in residential aged care,” she said.

Dementia deaths during the COVID-19 pandemic in Australia

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