Deep brain stimulation in the treatment of refractory obsessive-compulsive disorder: a literature review.

Aim Of The Study: The aim of this review is to present the overview of DBS outcomes for OCD. Moreover, we have discussed the current OCD pathophysiology with its implications for DBS. We have also presented the current indications and contraindications for DBS in OCD patients as well as still existing limitations in neuromodulation for OCD.

Methods: We have performed a literature review of DBS studies for OCD. We have found 8 well-conducted trials or open label trials with at least 6 individuals in each trial. Other reports present the data of the case series or single case reports of OCD for DBS.

Results: A number of well-conducted trials have demonstrated that the response rates (more than 35 % YBOCS score reduction) of OCD symptomatology remain in 50 to 80 % range. The study individuals in these trials have proven refractoriness and severity of OCD. The most common adverse events are related to the stimulation and include hypomanic episodes, suicidal ideation and other mood changes.

Conclusions: Our review suggests that DBS for OCD cannot be regarded as an established therapy for OCD. DBS for OCD should be regarded as palliative treatment in severely affected patients, but it is not curative. DBS should be considered if available non-operative forms of OCD treatment have failed.