Universität zu Köln

Alonso, Pino ORCID: 0000-0002-5779-9111, Cuadras, Daniel ORCID: 0000-0001-8780-1764, Gabriels, Loes, Denys, Damiaan, Goodman, Wayne, Greenberg, Ben D., Jimenez-Ponce, Fiacro, Kuhn, Jens, Lenartz, Doris, Mallet, Luc ORCID: 0000-0001-8061-1167, Nuttin, Bart, Real, Eva, Segalas, Cinto ORCID: 0000-0002-0959-0356, Schuurman, Rick, du Montcel, Sophie Tezenas ORCID: 0000-0002-2866-4330 and Menchon, Jose M. (2015). Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Meta-Analysis of Treatment Outcome and Predictors of Response. PLoS One, 10 (7). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Background Deep brain stimulation (DBS) has been proposed as an alternative to ablative neurosurgery for severe treatment-resistant Obsessive-Compulsive Disorder (OCD), although with partially discrepant results probably related to differences in anatomical targetting and stimulation conditions. We sought to determine the efficacy and tolerability of DBS in OCD and the existence of clinical predictors of response using meta-analysis. Methods We searched the literature on DBS for OCD from 1999 through January 2014 using PubMed/MEDLINE and PsycINFO. We performed fixed and random-effect meta-analysis with score changes (pre-post DBS) on the Yale-Brown Obsessive Compulsive Scale Y-BOCS) as the primary-outcome measure, and the number of responders to treatment, quality of life and acceptability as secondary measures. Findings Thirty-one studies involving 116 subjects were identified. Eighty-three subjects were implanted in striatal areas-anterior limb of the internal capsule, ventral capsule and ventral striatum, nucleus accumbens and ventral caudate-27 in the subthalamic nucleus and six in the inferior thalamic peduncle. Global percentage of Y-BOCS reduction was estimated at 45.1% and global percentage of responders at 60.0%. Better response was associated with older age at OCD onset and presence of sexual/religious obsessions and compulsions. No significant differences were detected in efficacy between targets. Five patients dropped out, but adverse effects were generally reported as mild, transient and reversible. Conclusions Our analysis confirms that DBS constitutes a valid alternative to lesional surgery for severe, therapy-refractory OCD patients. Well-controlled, randomized studies with larger samples are needed to establish the optimal targeting and stimulation conditions and to extend the analysis of clinical predictors of outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Alonso, Pino UNSPECIFIED orcid.org/0000-0002-5779-9111 UNSPECIFIED Cuadras, Daniel UNSPECIFIED orcid.org/0000-0001-8780-1764 UNSPECIFIED Gabriels, Loes UNSPECIFIED UNSPECIFIED UNSPECIFIED Denys, Damiaan UNSPECIFIED UNSPECIFIED UNSPECIFIED Goodman, Wayne UNSPECIFIED UNSPECIFIED UNSPECIFIED Greenberg, Ben D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jimenez-Ponce, Fiacro UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Lenartz, Doris UNSPECIFIED UNSPECIFIED UNSPECIFIED Mallet, Luc UNSPECIFIED orcid.org/0000-0001-8061-1167 UNSPECIFIED Nuttin, Bart UNSPECIFIED UNSPECIFIED UNSPECIFIED Real, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Segalas, Cinto UNSPECIFIED orcid.org/0000-0002-0959-0356 UNSPECIFIED Schuurman, Rick UNSPECIFIED UNSPECIFIED UNSPECIFIED du Montcel, Sophie Tezenas UNSPECIFIED orcid.org/0000-0002-2866-4330 UNSPECIFIED Menchon, Jose M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-398667
DOI:	10.1371/journal.pone.0133591
Journal or Publication Title:	PLoS One
Volume:	10
Number:	7
Date:	2015
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SUBTHALAMIC NUCLEUS STIMULATION; ANTERIOR CAPSULAR STIMULATION; ELECTRICAL-STIMULATION; MAJOR DEPRESSION; ACCUMBENS; DISEASE; PATIENT Multiple languages Multidisciplinary Sciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39866