Cognitive Outcome After Deep Brain Stimulation for Refractory Obsessive-Compulsive Disorder: A Systematic Review

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Science

Background:

• Deep brain stimulation (DBS) is an established treatment for refractory obsessive-compulsive disorder (OCD).
• Neuropsychological assessment is crucial for monitoring cognitive safety, identifying side effects, and understanding DBS treatment variability and mechanisms in OCD.

Purpose of the Study:

• To systematically review the cognitive safety of DBS for OCD.
• To explore if cognitive function changes explain the working mechanisms of DBS in OCD.

Main Methods:

• Systematic literature search of EMBASE, PubMed/Medline, Psycinfo, and Cochrane Library (completed November 2020).
• Included studies reporting cognitive outcomes following DBS for OCD.
• Appraisal of study design and quality using NHLBI tools.

Main Results:

• Analysis of 5 randomized controlled trials and 10 observational studies (178 patients).
• Observed variable outcomes in attention, memory, executive functioning, and cognitive flexibility.
• No consistent cognitive deterioration reported across individual studies.

Conclusions:

• Variability in study designs and cognitive measures prevented meta-analysis to confirm safety or identify a specific cognitive pattern for DBS efficacy in OCD.
• Future prospective studies require standardized neuropsychological batteries, focusing on executive functioning and longer follow-up.
• Uniform data collection may enhance understanding of DBS working mechanisms in OCD.