Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Deep Brain Stimulations for Obsessive-Compulsive Disorder: Update of the 2014 Guidelines
| Autor: | Clement Hamani, Nataly Raviv, Jonathan P. Miller, Julie G. Pilitsis, Jorge Gonzalez-Martinez, Michael D. Staudt, Guy M. McKhann, Nader Pouratian |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Obsessive-Compulsive Disorder
medicine.medical_specialty Evidence-based practice Deep brain stimulation Deep Brain Stimulation medicine.medical_treatment Nucleus Accumbens 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Thalamus Subthalamic Nucleus Obsessive compulsive medicine Humans Evidence-Based Medicine business.industry Task force Evidence-based medicine Guideline Congresses as Topic 030227 psychiatry Neurosurgeons Treatment Outcome Search terms Practice Guidelines as Topic Commentary Surgery CNS Deep Brain Stimulation for Obsessive Compulsive Disorder Guidelines Neurology (clinical) Level ii business 030217 neurology & neurosurgery |
| Zdroj: | Neurosurgery |
| ISSN: | 1524-4040 0148-396X |
| DOI: | 10.1093/neuros/nyaa596 |
| Popis: | BACKGROUND: In 2020, the Guidelines Task Force conducted another systematic review of the relevant literature on deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) to update the original 2014 guidelines to ensure timeliness and accuracy for clinical practice. OBJECTIVE: To conduct a systematic review of the literature and update the evidence-based guidelines on DBS for OCD. METHODS: The Guidelines Task Force conducted another systematic review of the relevant literature, using the same search terms and strategies as used to search PubMed and Embase for relevant literature. The updated search included studies published between 1966 and December 2019. The same inclusion/exclusion criteria as the original guideline were also applied. Abstracts were reviewed and relevant full-text articles were retrieved and graded. Of 864 articles, 10 were retrieved for full-text review and analysis. Recommendations were updated according to new evidence yielded by this update. RESULTS: Seven studies were included in the original guideline, reporting the use of bilateral DBS as more effective in improving OCD symptoms than sham treatment. An additional 10 studies were included in this update: 1 class II and 9 class III. CONCLUSION: Based on the data published in the literature, the following recommendations can be made: (1) It is recommended that clinicians utilize bilateral subthalamic nucleus DBS over best medical management for the treatment of patients with medically refractory OCD (level I). (2) Clinicians may use bilateral nucleus accumbens or bed nucleus of stria terminalis DBS for the treatment of patients with medically refractory OCD (level II). There is insufficient evidence to make a recommendation for the identification of the most effective target. The full guidelines can be accessed at https://www.cns.org/guidelines/browse-guidelines-detail/deep-brain-stimulation-obsessive-compulsive-disord. |
| Databáze: | OpenAIRE |
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