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Article History

Received: 29 July 2024

Revised: 14 March 2025

Accepted: 27 March 2025

First Online: 6 April 2025

Competing interests

: VAC and TES as employees of University of Freiburg, listed by the institution as inventors, have filed a U.S. provisional patent application generally related to highly focused DBS in the treatment of OCD (U.S. Patent Application Number 63/253740). Unrelated: VAC receives a collaborative grant from BrainLab (Munich, Germany). He is a consultant for Ceregate (Munich, Germany), Cortec (Freiburg, Germany) and Inbrain (Barcelona, Spain). He has an ongoing IIT with Boston Scientific (USA) and has received personal honoraria and travel support for lecture work from Boston Scientific (USA), ALEVA, UNEEG and PRECISIS. Unrelated: MP has received financial support for investigator-initiated trials from Boston Scientific and honoraria for lecturing or consultation from Lundbeck. Unrelated: SC has received honoraria for consultation from Medtronic, Boston Scientific. Unrelated: PCR has received research support from Else Kröner-Fresenius Foundation, Fraunhofer Foundation (ATTRACT), German Ministry for Economic Affairs and Energy, and Medical Faculty of the University of Freiburg. He has received personal honoraria for lectures or advice from Fraunhofer Foundation and is a consultant for Boston Scientific, Brainlab, and Inomed. DMD receives research support from Evangelisches Studienwerk e.V. and Wissenschaftliche Gesellschaft Freiburg im Breisgau. JCB is funded by the Else-Kröner-Fresenius-Stiftung (2022_EKES.23). BEAS received a research grant from Ceregate (Munich, Germany) and received honoraria as a consultant for Precisis, Heidelberg, both unrelated to this work. All other authors declare no conflicts of interest.

: a) All methods were performed in accordance with relevant guidelines and regulations. b) Freiburg: Patients with TR-OCD who previously had received bilateral slMFB-DBS were selected for analysis, if they gave informed consent to our DBS registry that adheres to the principles of the Helsinki Declaration and received approval from institutional review board (Ethics Committee of Freiburg University; no.21-1274). Grenoble: The publication of results had previously been discussed [] and waived on the basis of a national committee decision: Comité consultatif National d’ethique. La neurochirurgie fonctionnelle D affectionspsychiatriques severes 2002. c) Freiburg: Patients gave written informed consent. Grenoble: Written consent was obtained for surgery. For publication, based on national guidelines no written consent was necessary (see b).