The use of bilateral anterior limb of internal capsule (ALIC) DBS for OCD was approved by the US Food and Drug Administration (FDA) under a humanitarian device exemption (HDE) in 2009.9 Following this HDE approval and publication of the 2014 CNS guidelines, there have been additional published studies reporting the use of DBS for OCD, although most do not meet criteria to be included in this guidelines update. The purpose of this update is to review the literature following publication of the original guidelines and to update the recommendations as appropriate. Based on the availability of new literature, the current guideline is a major update resulting in modification and update of prior recommendations as well as an updated discussion.

J. Bradley Elder, MD

Julie G. Pilitsis, MD, PhD

Nader Pouratian, MD, PhD

Michael D. Staudt, MD, MSc

Vin Shan Ban, MD

Joravar Dhaliwal, MD

Megan Still, MD