Therapeutic Neurostimulation in Obsessive-Compulsive and Related Disorders: A Systematic Review

Acevedo, Nicola; Bosanac, Peter; Pikoos, Toni D; Rossell, Susan L.; Castle, David

doi:10.3390/brainsci11070948

Cited by 38 publications

(38 citation statements)

References 254 publications

(545 reference statements)

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“…Numerous studies have investigated the effects of tDCS in the treatment of refractory OCD. The targets selected were the same as those used for TMS, including pre-SMA/SMA, mPFC, DLPFC, and OFC ( 84 ).…”

Section: Methods Of Neuromodulationmentioning

confidence: 99%

“…Despite good response and remission rates of ALIC stimulation, its clinical usefulness is somewhat constrained by the high stimulation intensity required for beneficial results ( 84 , 119 ). Most clinical studies show effectiveness with ALIC stimulation only after extensive programming and with amplitudes of 5–10 V. Compared to DBS for movement disorders (Parkinson's disease, essential tremor, dystonia), amplitudes at this intensity necessitate frequent replacement of the implantable-pulse-generator.…”

Section: Methods Of Neuromodulationmentioning

confidence: 99%

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Neuromodulation of OCD: A review of invasive and non-invasive methods

et al. 2022

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Early research into neural correlates of obsessive compulsive disorder (OCD) has focused on individual components, several network-based models have emerged from more recent data on dysfunction within brain networks, including the the lateral orbitofrontal cortex (lOFC)-ventromedial caudate, limbic, salience, and default mode networks. Moreover, the interplay between multiple brain networks has been increasingly recognized. As the understanding of the neural circuitry underlying the pathophysiology of OCD continues to evolve, so will too our ability to specifically target these networks using invasive and noninvasive methods. This review discusses the rationale for and theory behind neuromodulation in the treatment of OCD.

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Section: Methods Of Neuromodulationmentioning

confidence: 99%

Section: Methods Of Neuromodulationmentioning

confidence: 99%

Neuromodulation of OCD: A review of invasive and non-invasive methods

et al. 2022

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“…Standard values have largely been adopted from movement disorder applications and may not be optimal for psychiatric conditions. Refinement of stimulation parameters, particularly the location, is a critical factor in achieving the best outcomes (Acevedo et al, 2021). Currently, the only established method is the Montgomery algorithm (Montgomery, 2010), which is not condition-specific, and deviations may be necessary when managing difficult cases, which comes with practical experience and cannot be described in a series of simple steps.…”

Section: Post-operativementioning

confidence: 99%

“…Furthermore, the Mental Health Act prohibits DBS for OCD in New South Wales, and the Northern Territory. In our recent systematic review (Acevedo et al, 2021), we identified several disparities in treatment approaches, which can confound patient outcomes, highlighting the need for standardization. Currently, there are no clinical guidelines or expert consensus outlining best practice in managing OCD DBS patients.…”

mentioning

confidence: 99%

Clinical recommendations for the care of people with treatment-refractory obsessive-compulsive disorder when undergoing deep brain stimulation

Acevedo

Castle

Groves³

et al. 2022

Aust N Z J Psychiatry

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Deep brain stimulation is an emerging therapy for treatment-refractory obsessive-compulsive disorder patients. Yet, accessibility is limited, treatment protocols are heterogeneous and there is no guideline or consensus on the best practices. Here, we combine evidence from scientific investigations, expert opinions and our clinical expertise to propose several clinical recommendations from the pre-operative, surgical and post-operative phases of deep brain stimulation care for treatment-refractory obsessive-compulsive disorder patients. A person-centered and biopsychosocial approach is adopted. Briefly, we discuss clinical characteristics associated with response, the use of improved educational materials, an evaluative consent process, comprehensive programming by an expert clinician, a more global assessment of treatment efficacy, multi-disciplinary adjunct psychotherapy and the importance of peer support programs. Furthermore, where gaps are identified, future research suggestions are made, including connectome surgical targeting, scientific evaluation of hardware models and health economic data. In addition, we encourage collaborative groups of data and knowledge sharing by way of a clinical registry and a peer group of programming clinicians. We aim to commence a discussion on the determinants of deep brain stimulation efficacy for treatment-refractory obsessive-compulsive disorder patients, a rare and severe patient group, and contribute to more standardized and evidence-based practices.

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“…103 A systematic review on clinical responses to several DBS targets in patients with TS showed fiber connectivity to be important in target selection because the effects of DBS on tics seem to occur through different networks at different stimulation sites. 104 Finally, an interesting case report described a patient with major depressive disorder who developed voltage-dependent coprolalia and tic-like movements along with changes in emotion, mood, and memory after DBS of bilateral ventral internal capsule and ventral striatum. 105…”

Section: Medicationmentioning

confidence: 99%