• First report of bilateral nucleus accumbens–anterior limb of the internal capsule (NAc–ALIC) combined with medial globus pallidus (GPi) deep brain stimulation (DBS) for treating obsessive–compulsive disorder (OCD) comorbid with tardive dyskinesia (TD). • The combined DBS achieved a 96.15% improvement in Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) and 95% improvement in Abnormal Involuntary Movement Scale (AIMS) with a 30-month follow-up, showing stable mid-to-long-term efficacy. • No serious complications (e.g., intracranial hemorrhage, infection, permanent neurological deficit) occurred during the entire follow-up period, confirming the good safety of the dual-target DBS strategy. • The synergistic effect of combined DBS was realized by precise modulation of the core pathological circuits of OCD and TD, correcting cortico-striato-thalamo-cortical (CSTC) circuit dysfunction and restoring dopaminergic system balance respectively. • The dual-target DBS presented superior therapeutic effects to single-target DBS for either OCD or TD alone, and provided novel and effective clinical evidence for the treatment of drug-refractory psychiatric-movement disorder comorbidities. To preliminarily explore the mid‑ to long‑term efficacy and safety of bilateral nucleus accumbens–anterior limb of the internal capsule (NAc–ALIC) stimulation combined with medial globus pallidus (GPi) stimulation for treating obsessive‑compulsive disorder (OCD) complicated by tardive dyskinesia (TD). In May 2023, one patient with OCD complicated by TD underwent bilateral NAc–ALIC and GPi deep brain stimulation (DBS) at the Department of Neurosurgery IV, the First Affiliated Hospital of Xinjiang Medical University. Clinical efficacy and safety were retrospectively analyzed. The Yale–Brown Obsessive‑Compulsive Scale (Y‑BOCS) was used to assess OCD symptoms, and the Abnormal Involuntary Movement Scale (AIMS) was used to assess TD severity. The patient was followed for 30 months to evaluate outcomes and possible adverse events. At 6 months after stimulator activation, Y‑BOCS and AIMS improvement rates were 73.07% and 70%, respectively; at 12 months, 88.46% and 90%; and at 30 months, 96.15% and 95%. No serious complications such as intracranial hemorrhage, infection, or permanent neurological deficit occurred. Bilateral NAc–ALIC combined with GPi DBS may represent a safe and effective therapeutic option for treatment‑resistant OCD accompanied by TD, showing stable mid‑ to long‑term efficacy.
Abudukeyimu et al. (Sun,) studied this question.