Commentary: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Deep Brain Stimulations for Obsessive Compulsive Disorder: Update of the 2014 Guidelines

Neurosurgery ◽  
2021 ◽  
Author(s):  
Jaimie M Henderson
Keyword(s):  
Systematic Review ◽  
Obsessive Compulsive Disorder ◽  
Evidence Based ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Evidence Based Guidelines ◽  
Deep Brain

scholarly journals Neurocircuitry of Deep Brain Stimulation for Obsessive-Compulsive Disorder as Revealed by Tractography: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Eduardo Varjão Vieira ◽  
Paula Ricci Arantes ◽  
Clement Hamani ◽  
Ricardo Iglesio ◽  
Kleber Paiva Duarte ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Brain Stimulation ◽  
White Matter ◽  
Data Processing ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Diffusion Tensor ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

Objective: Deep brain stimulation (DBS) was proposed in 1999 to treat refractory obsessive-compulsive disorder (OCD). Despite the accumulated experience over more than two decades, 30–40% of patients fail to respond to this procedure. One potential reason to explain why some patients do not improve in the postoperative period is that DBS might not have engaged structural therapeutic networks that are crucial to a favorable outcome in non-responders. This article reviews magnetic resonance imaging diffusion studies (DTI-MRI), analyzing neural networks likely modulated by DBS in OCD patients and their corresponding clinical outcome.Methods: We used a systematic review process to search for studies published from 2005 to 2020 in six electronic databases. Search terms included obsessive-compulsive disorder, deep brain stimulation, diffusion-weighted imaging, diffusion tensor imaging, diffusion tractography, tractography, connectome, diffusion analyses, and white matter. No restriction was made concerning the surgical target, DTI-MRI technique and the method of data processing.Results: Eight studies published in the last 15 years were fully assessed. Most of them used 3 Tesla DTI-MRI, and different methods of data acquisition and processing. There was no consensus on potential structures and networks underlying DBS effects. Most studies stimulated the ventral anterior limb of the internal capsule (ALIC)/nucleus accumbens. However, the contribution of different white matter pathways that run through the ALIC for the effects of DBS remains elusive. Moreover, the improvement of cognitive and affective symptoms in OCD patients probably relies on electric modulation of distinct networks.Conclusion: Though, tractography is a valuable tool to understand neural circuits, the effects of modulating different fiber tracts in OCD are still unclear. Future advances on image acquisition and data processing and a larger number of studies are still required for the understanding of the role of tractography-based targeting and to clarify the importance of different tracts for the mechanisms of DBS.

scholarly journals Estimulação Cerebral Profunda em Transtorno Obsessivo Compulsivo – Um Estudo de Revisão Sistemática / Deep Brain Stimulation in Obsessive Compulsive Disorder - A Systematic Review Study

2020 ◽  
Vol 3 (6) ◽  
pp. 16197-16203
Author(s):  
Luiz Henrique Salamoni Abad ◽  
João Vítor Andrade Fortuna Abrantes ◽  
Dominique Hayduk Montecino ◽  
Gabriel Rodrigues Carvalho ◽  
Laura Assis de Castro Paletta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Review Study ◽  
Deep Brain

scholarly journals Deep Brain Stimulation for Obsessive-Compulsive Disorder

Neurosurgery ◽  
2014 ◽  
Vol 75 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Clement Hamani ◽  
Julie Pilitsis ◽  
Anand I. Rughani ◽  
Joshua M. Rosenow ◽  
Parag G. Patil ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Class Ii ◽  
Class I ◽  
Evidence Based ◽  
Obsessive Compulsive ◽  
Single Class ◽  
Compulsive Disorder ◽  
Deep Brain

Abstract BACKGROUND: It is estimated that 40% to 60% of patients with obsessive-compulsive disorder (OCD) continue to experience symptoms despite adequate medical management. For this population of treatment-refractory patients, promising results have been reported with the use of deep brain stimulation (DBS). OBJECTIVE: To conduct a systematic review of the literature and develop evidence-based guidelines on DBS for OCD. METHODS: A systematic literature search was undertaken using the PubMed database for articles published between 1966 and October 2012 combining the following words: “deep brain stimulation and obsessive-compulsive disorder” or “electrical stimulation and obsessive-compulsive disorder.” Of 353 articles, 7 were retrieved for full-text review and analysis. The quality of the articles was assigned to each study and the strength of recommendation graded according to the guidelines development methodology of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Joint Guidelines Committee. RESULTS: Of the 7 studies, 1 class I and 2 class II double-blind, randomized, controlled trials reported that bilateral DBS is more effective in improving OCD symptoms than sham treatment. CONCLUSION: Based on the data published in the literature, the following recommendations can be made: (1) There is Level I evidence, based on a single class I study, for the use of bilateral subthalamic nucleus DBS for the treatment of medically refractory OCD. (2) There is Level II evidence, based on a single class II study, for the use of bilateral nucleus accumbens DBS for the treatment of medically refractory OCD. (3) There is insufficient evidence to make a recommendation for the use of unilateral DBS for the treatment of medically refractory OCD.

scholarly journals Estimulação Cerebral Profunda em Transtorno Obsessivo Compulsivo – Um Estudo de Revisão Sistemática / Deep Brain Stimulation in Obsessive Compulsive Disorder - A Systematic Review Study

2020 ◽  
Vol 3 (5) ◽  
pp. 15389-15395
Author(s):  
Luiz Henrique Salamoni Abad ◽  
João Vítor Andrade Fortuna Abrantes ◽  
Dominique Hayduk Montecino ◽  
Gabriel Rodrigues Carvalho ◽  
Laura Assis de Castro Paletta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Review Study ◽  
Deep Brain

scholarly journals Deep Brain Stimulation of the Habenula: Systematic Review of the Literature and Clinical Trial Registries

2021 ◽  
Vol 12 ◽  
Author(s):  
Jürgen Germann ◽  
Manuel Mameli ◽  
Gavin J. B. Elias ◽  
Aaron Loh ◽  
Alaa Taha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Clinical Trials ◽  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

The habenula is a small bilateral epithalamic structure that plays a key role in the regulation of the main monoaminergic systems. It is implicated in many aspects of behavior such as reward processing, motivational behavior, behavioral adaptation, and sensory integration. A role of the habenula has been indicated in the pathophysiology of a number of neuropsychiatric disorders such as depression, addiction, obsessive-compulsive disorder, and bipolar disorder. Neuromodulation of the habenula using deep brain stimulation (DBS) as potential treatment has been proposed and a first successful case of habenula DBS was reported a decade ago. To provide an overview of the current state of habenula DBS in human subjects for the treatment of neuropsychiatric disorders we conducted a systematic review of both the published literature using PUBMED and current and past registered clinical trials using ClinicalTrials.gov as well as the International Clinical Trials Registry Platform. Using PRISMA guidelines five articles and five registered clinical trials were identified. The published articles detailed the results of habenula DBS for the treatment of schizophrenia, depression, obsessive-compulsive disorder, and bipolar disorder. Four are single case studies; one reports findings in two patients and positive clinical outcome is described in five of the six patients. Of the five registered clinical trials identified, four investigate habenula DBS for the treatment of depression and one for obsessive-compulsive disorder. One trial is listed as terminated, one is recruiting, two are not yet recruiting and the status of the fifth is unknown. The planned enrollment varies between 2 to 13 subjects and four of the five are open label trials. While the published studies suggest a potential role of habenula DBS for a number of indications, future trials and studies are necessary. The outcomes of the ongoing clinical trials will provide further valuable insights. Establishing habenula DBS, however, will depend on successful randomized clinical trials to confirm application and clinical benefit of this promising intervention.

Deep brain stimulation and treatment-resistant obsessive-compulsive disorder: A systematic review

2019 ◽  
Vol 12 (1) ◽  
pp. 37-51 ◽  
Author(s):  
Javier Vázquez-Bourgon ◽  
Juan Martino ◽  
María Sierra Peña ◽  
Jon Infante Ceberio ◽  
M. Ángeles Martínez Martínez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain
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