{"id":"a5c8fd45-f300-4550-bc87-ed65afca3186","slug":"sni-17-408","title":"Bilateral deep brain stimulation for the treatment of body dysmorphic disorder and obsessive-compulsive disorder","authors":["Andrew Ghannad","Maria Isabella Burritt St. Angelo","Oleksandr Strelko","Andreas Runde","Aanya Agarwal","Nikolas A. Corrales","Kelly Goldstein","Daryn K. Cass","Anand V. Germanwala","Douglas E. Anderson"],"abstract":"Background: Body dysmorphic disorder (BDD) is classified under obsessive-compulsive and related disorders. BDD is characterized by intense preoccupation with the perception of deficits or flaws in appearance, with repetitive behaviors manifested by altered self-perception. These symptoms bring about significant distress, making normal functioning difficult. Patients tend to respond to a combination of cognitive and pharmacologic therapies, similar to the treatment responses of patients with other obsessive-compulsive spectrum disorders. However, in severe cases of intractable BDD when multiple modalities of therapy have failed, other treatments such as deep brain stimulation (DBS) could be considered. Case Description: A 23-year-old Caucasian male presents with a 5-year history of worsening BDD, OCD, and social phobia. A combination of cognitive behavioral therapy and standard pharmacological treatment was attempted, but symptoms progressed, leading to suicidal ideation. Ultimately, the patient elected to undergo placement of a DBS device bilaterally targeting the region bound by the ventral striatum, nucleus accumbens, and subgenual cingulate. The patient was evaluated using both the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist and the Hamilton Rating Scale for Depression, both pre and postoperatively over the course of 21.5 months. Conclusion: Following DBS treatment, this patient demonstrated marked improvements in BDD-associated symptoms previously resistant to both cognitive behavioral and pharmacological therapy. This case highlights how DBS treatment can effectively improve symptoms in treatment-refractory BDD when first-line modalities have been exhausted and thus may be a potential consideration for clinical use.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/sni-17-408/figures/SNI-17-408-g001.jpg","publishDate":"2026-07-17T00:00:00.000Z","doi":"10.25259/SNI_256_2026","categories":["Stereotactic","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/a5c8fd45-f300-4550-bc87-ed65afca3186/pdf"}