HealthDay News — Deep brain stimulation (DBS) may reduce symptoms in patients with treatment-resistant obsessive-compulsive disorder, according to a systematic review and meta-analysis published online Sept. 20 in the Journal of Neurology, Neurosurgery & Psychiatry.
Ron Gadot, from the Baylor College of Medicine in Houston, and colleagues examined current evidence on the efficacy of DBS in alleviating OCD and comorbid depressive symptoms. Studies reporting primary data on multiple patients who received DBS therapy with outcomes reported through the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were included. Data were reviewed from 34 studies from 2005 to 2021, including nine randomized controlled trials (RCTs) with 97 patients and 25 non-RCTs with 255 patients.
The researchers found a 47 percent reduction in Y-BOCS scores in the random-effects model, with no significant difference between RCTs and non-RCTs. Sixty-six percent of patients were full responders to DBS therapy at last follow-up. A low likelihood of small study effect bias was seen in reported outcomes in sensitivity analyses. In a secondary analysis, there was a one standardized effect size (Hedges’ g) reduction in depressive scale symptoms.
“Our findings support DBS as an effective treatment for treatment-resistant obsessive-compulsive disorder, and the average appropriately selected patient will experience OCD symptom reduction of about 50 percent,” the authors write. “Future crossover RCTs should aim to consistently include washout periods between active and sham stimulation periods, while observational and open-label clinical studies should aim to minimize potential confounders of treatment response and maintain longer follow-up protocols.”
Two authors disclosed financial ties to the pharmaceutical and health care industries.