Deep brain stimulation for obsessive-compulsive disorder: a systematic review and meta-analysis

Area of Science:

• Neuroscience
• Psychiatry
• Medical Research

Background:

• Deep brain stimulation (DBS) is an emerging treatment for psychiatric disorders like OCD, depression, and anorexia nervosa.
• Limited double-blind, randomized controlled trials (RCTs) exist for DBS in psychiatric conditions.
• A systematic review and meta-analysis were conducted to increase statistical power and assess DBS effectiveness.

Purpose of the Study:

• To systematically review and meta-analyze the effectiveness of DBS in psychiatric conditions.
• To evaluate the efficacy of active DBS compared to sham treatment.
• To identify the current state of evidence for DBS in psychiatric disorders.

Main Methods:

• Systematic literature search for double-blind RCTs of active vs. sham DBS.
• Searched databases included Pubmed/Medline and EMBASE up to April 2013.
• Meta-analysis combined data from eligible studies, analyzing final scores and changes from baseline.

Main Results:

• Five studies, all on OCD, met inclusion criteria, with 44 subjects in the meta-analysis.
• Active DBS significantly reduced obsessive symptoms (YBOCS score: MD -8.93, p < 0.001) compared to sham.
• One-third of patients experienced significant adverse effects; no differences were found for other outcomes.

Conclusions:

• DBS shows potential for treatment-resistant OCD.
• Insufficient randomized controlled data exist for DBS in other psychiatric conditions.
• DBS remains an experimental treatment for severe, refractory adult psychiatric conditions pending further research.