Have you ever wondered about using deep brain stimulation? DBS. For kids dealing with obsessive compulsive disorder? OCD. It's a hot topic among parents, but do we have enough evidence to back up this rather intense treatment? Let's dive in and take a closer look at deep brain stimulation. Welcome to the Carlats psychiatry podcast. This is another special episode from the Child Psychiatry Dean. I'm Dr. Josh Bader, the editor-in-chief of the Carlats Psychiatry Report and co-author of the Child Medication Factbook for Psychiatric Practice, Second Edition, 2023, and the other book for Scribing Psychotropics. In America, a licensed clinical social worker in Southern California with a private practice and an avid reader of the Carlats Psychiatry Report. Today we are looking at deep brain stimulation, as influenced by Dr. John Race article in our Carlats Trial Psychiatry Report October, November, December, 2023 issue. To start, let's lay the groundwork for deep brain stimulation. Dr. Bader, could you share some insight into how this technique operates? Sure, deep brain stimulation, DDS, may be described as a high-tech fix for certain brain-related issues. Fix might be a generous word. Its mechanism involves modulating hyperactive brain networks by delivering controlled electrical stimulation to precise brain regions using an implanted pulse generator in the chest wall. Imagine this, tiny electrodes get implanted into specific spots in the brain, tied to things like Parkinson's tremors or OCD symptoms. These electrodes link up to a gadget similar to a pacemaker snug under your skin around the chest. This gadget sends out steady electrical pulses, calming down those brain areas that are acting up. Kind of like a pacemaker for the brain. When other treatments fall short or cause problems, DBS steps in. It's reversible so they can tweak or remove the device, but it's not a walk in the park. It involves surgery and needs careful monitoring to fine-tune the settings and get the best results with fewer side effects. Thanks for the helpful visual. While we're on the topic, we can also describe the other component to our discussion today, OCD, obsessive compulsive disorder, is a mental health condition marked by recurring intrusive thoughts, obsessions and repetitive behaviors or mental acts, compulsions.