A Systematic Review of Treatment Outcome Predictors in Deep Brain Stimulation for Refractory Obsessive-Compulsive Disorder

Abstract

Obsessive-compulsive disorder (OCD) is a chronic and debilitating mental disorder. Deep brain stimulation (DBS) is a promising approach for refractory OCD patients. Research aiming at treatment outcome prediction is vital to provide optimized treatments for different patients. The primary purpose of this systematic review was to collect and synthesize studies on outcome prediction of OCD patients with DBS implantations in recent years. This systematic review (PROSPERO registration number: CRD42022335585) followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis) guidelines. The search was conducted using three different databases with the following search terms related to OCD and DBS. We identified a total of 3814 articles, and 17 studies were included in our review. A specific tract confirmed by magnetic resonance imaging (MRI) was predictable for DBS outcome regardless of implant targets, but inconsistencies still exist. Current studies showed various ways of successful treatment prediction. However, considering the heterogeneous results, we hope that future studies will use larger cohorts and more precise approaches for predictors and establish more personalized ways of DBS surgeries.

Presurgical structural imaging and clinical outcome in combined bed nucleus of the stria terminalis–nucleus accumbens deep brain stimulation for treatment-resistant depression

“…Differences in fibre properties have been shown to correlate with DBS outcomes in conditions such as Parkinson’s disease and obsessive–compulsive disorder. 4 5 In the treatment of TRD, frontal volumes and frontal white matter (WM) structure were reported to correlate with the DBS outcome of the superolateral medial forebrain bundle (slMFB). 6 A large profile of WM tracts, especially tracts connecting the medial frontal area, was associated with DBS response in patients who received subcallosal cingulate cortex DBS.…”