Long-term clinical outcomes of the utilization of Deep Brain Stimulation (DBS) in the treatment of refractory Obsessive-Compulsive Disorder (OCD): a systematic review.
Lorena Silva dos Reis1, Maria Clara Rêgo de Araújo1, Beatriz do Nascimento Garcia Moreno1, Blenda Antunes Cacique Curcino de Eça1, Daniel Fernandes Silva Marques1, Teresa Neves da Rocha Correia1.
1.Medicine students at Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
OBJECTIVE: To analyze the long-term clinical outcomes of Deep Brain Stimulation (DBS) in the treatment of refractory Obsessive-Compulsive Disorder (OCD) based on response verification (reduction in the Yale–Brown Obsessive Compulsive Scale score, or Y-BOCS, ? 35%) in the last follow-up of patients who underwent the procedure.
METHODS: The PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used to guide a systematic review of the literature. In the PubMed database, the following search formula was applied: (((("long term effects") OR (late follow-up) OR (long-term outcomes) AND ("deep brain stimulation") AND ("obsessive compulsive disorder))))". Follow-up studies (of pre-existing clinical trials) published in the last 10 years and in English were included. Each patient’s data were reviewed, except for those with time until last follow-up inferior to 24 months
RESULTS: 27 articles were found, of which five met all the selection criteria. Of the 57 total patients, 51 had their data analyzed. The median time until last follow-up was 51 months (longest= 171 months; shortest= 24 months), with an interquartile range of 56. 67.5% of patients achieved response criterion. Of these, 47.2% reached remission of OCD (Y-BOCS score ? 12).
CONCLUSIONS: Due to the considerable percentage of positive outcomes, the treatment of OCD with DBS looks promising. However, an accurate interpretation of the results is hampered by the discrepancies in the follow-up times and the small number of participants (N). Future randomized-blind, multicentric and/or higher N trials are needed for the technique to have its long-term effectiveness firmly proven.
KEYWORDS: Obsessive-Compulsive Disorder; Deep Brain Stimulation; long term effects.
FUNDING/FINANCIAL SUPPORT: None