Deep brain stimulation for obsessive-compulsive disorder: A systematic review of randomised controlled trials. (February 2020)

• Record Type: Journal Article
• Authors: Vicheva, Petya; Butler, Matthew; Shotbolt, Paul
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 109(2020)
• Page Start: 129
• Page End: 138
• Publication Date: 2020-02
• Subjects: Deep brain stimulation -- Treatment-resistant obsessive-compulsive disorder -- Functional neurosurgery -- Neuromodulation -- Neuropsychiatry -- Systematic review; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2020.01.007
• Languages: English
• ISSNs: 0149-7634

Abstract

Highlights: Deep brain stimulation is an effective treatment for obsessive-compulsive disorder. Effects of deep brain stimulation on affective state are ambiguous. Impact of deep brain stimulation on quality of life and cognition needs further investigation. There is a need for clinical trials and standardisation of study methodology to address further questions. 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.