Citation

Vicheva P, Butler M, Shotbolt P. Neurosci. Biobehav. Rev. 2020; 109: 129-138.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.neubiorev.2020.01.007

PMID

31923474

Abstract

Deep brain stimulation (DBS) is considered a promising intervention for treatment-resistant obsessive-compulsive disorder (trOCD). We conducted a systematic search to investigate the efficacy and safety of DBS for OCD. Primary outcomes included the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), adverse events (AE), and quality of life. We assessed affective state, global functioning, cognition, and tolerability as secondary outcomes. Eight studies comprising 80 patients with trOCD were analysed both individually and collectively. We found a pooled mean reduction in Y-BOCS of 38.68 %, indicating DBS could be considered an effective therapy for trOCD. Most AE were mild and transient, however there were five severe surgery-related AE: intracerebral haemorrhage in three patients and infection in two. Mood-related serious AE were one completed suicide, three suicide attempts in two patients, and suicidal thoughts and depression in four. Despite this, affective state improved following stimulation. Despite being limited by significant heterogeneity across studies, our review has shown DBS to be an effective treatment in otherwise trOCD. There is a need to standardise study methodology in future research.

Language: en

Keywords

Humans; Randomized Controlled Trials as Topic; Systematic review; Outcome Assessment, Health Care; Obsessive-Compulsive Disorder; Neuropsychiatry; Deep Brain Stimulation; Deep brain stimulation; Neuromodulation; Functional neurosurgery; Treatment-resistant obsessive-compulsive disorder