Application of Deep Brain Stimulation for Treatment-resistant Obsessive Compulsive Disorder: Current Status and...

Area of Science:

• Neurosurgery
• Psychiatry
• Neurology

Background:

• Deep brain stimulation (DBS) is a standard treatment for neurological disorders like Parkinson's disease in Japan.
• DBS has demonstrated efficacy and safety for treatment-resistant obsessive compulsive disorder (OCD) in the EU and USA.
• Japan currently does not utilize DBS for psychiatric disorders, including OCD, due to a 1975 policy against psychosurgery.

Purpose of the Study:

• To review the scientific evidence and clinical application of DBS for psychiatric disorders, specifically OCD.
• To address the lack of scientific understanding and consideration of DBS in Japanese psychiatry.
• To encourage a re-evaluation of DBS for treatment-resistant OCD in Japan based on objective data.

Main Methods:

• Systematic review of existing literature on DBS for neurological and psychiatric disorders.
• Analysis of randomized controlled trials and meta-analyses concerning DBS efficacy and safety.
• Examination of regulatory approvals and clinical practices in Western countries versus Japan.

Main Results:

• DBS is approved and widely used for neurological conditions in Japan.
• Evidence supports the efficacy and safety of DBS for treatment-resistant OCD in the US and EU.
• A significant gap exists in Japan regarding the clinical application and scientific discourse on DBS for psychiatric disorders.

Conclusions:

• There is an urgent need for additional treatment options for individuals with treatment-resistant OCD in Japan.
• The historical "Resolution of total denial for psychosurgery" hinders the consideration of DBS for psychiatric conditions.
• A thorough, evidence-based discussion is necessary to re-evaluate the potential of DBS for treating psychiatric disorders like OCD in Japan.