TY - JOUR
T1 - Cognitive Outcome After Deep Brain Stimulation for Refractory Obsessive-Compulsive Disorder: A Systematic Review
AU - van der Vlis, T.A.M.B.
AU - Duits, A.
AU - van de Veerdonk, M.M.G.H.
AU - Mulders, A.E.P.
AU - Schruers, K.R.J.
AU - Temel, Y.
AU - Ackermans, L.
AU - Leentjens, A.F.G.
N1 - Funding Information:
Source(s) of financial support: This research received no specific grant from any funding agency in the public, commercial, or not‐for‐profit sectors.
Publisher Copyright:
© 2021 The Authors
PY - 2022/2
Y1 - 2022/2
N2 - Introduction Deep brain stimulation (DBS) is an effective treatment for refractory obsessive-compulsive disorder (OCD). Neuropsychological assessment contributes to DBS treatment in several ways: it monitors the cognitive safety of the treatment, identifies beneficial or detrimental cognitive side effects and it could aid to explain variability in treatment outcome, and possibly the treatment's working mechanism(s). Background This systematic review assessed the cognitive safety of DBS for OCD and explored whether changes in cognitive function may help explain its working mechanism(s). Materials and Methods EMBASE, PubMed/Medline, Psycinfo, and the Cochrane Library were systematically searched for studies reporting cognitive outcomes following DBS for OCD. Searches were completed in November 2020. Included studies were appraised for study design and quality according to National Heart, Lung and Blood Institute (NHLBI) quality assessment tools. Results Five randomized controlled trials and ten observational studies comprising a total of 178 patients were analyzed collectively. Variable outcomes of DBS were observed in the domains of attention, memory, executive functioning, and in particular cognitive flexibility. Conclusion Although individual studies generally do not report cognitive deterioration after DBS for OCD, the variability of study designs and the multitude of cognitive measures used, precluded a meta-analysis to confirm its safety, and recognition of a cognitive pattern through which the efficacy of DBS for OCD might be explained. In future, prospective studies should preferably include a standardized neuropsychological assessment battery specifically addressing executive functioning and have a longer-term follow-up in order to demonstrate the cognitive safety of the procedure. Such prospective and more uniform data collection may also contribute to our understanding of the working mechanisms of DBS in OCD.
AB - Introduction Deep brain stimulation (DBS) is an effective treatment for refractory obsessive-compulsive disorder (OCD). Neuropsychological assessment contributes to DBS treatment in several ways: it monitors the cognitive safety of the treatment, identifies beneficial or detrimental cognitive side effects and it could aid to explain variability in treatment outcome, and possibly the treatment's working mechanism(s). Background This systematic review assessed the cognitive safety of DBS for OCD and explored whether changes in cognitive function may help explain its working mechanism(s). Materials and Methods EMBASE, PubMed/Medline, Psycinfo, and the Cochrane Library were systematically searched for studies reporting cognitive outcomes following DBS for OCD. Searches were completed in November 2020. Included studies were appraised for study design and quality according to National Heart, Lung and Blood Institute (NHLBI) quality assessment tools. Results Five randomized controlled trials and ten observational studies comprising a total of 178 patients were analyzed collectively. Variable outcomes of DBS were observed in the domains of attention, memory, executive functioning, and in particular cognitive flexibility. Conclusion Although individual studies generally do not report cognitive deterioration after DBS for OCD, the variability of study designs and the multitude of cognitive measures used, precluded a meta-analysis to confirm its safety, and recognition of a cognitive pattern through which the efficacy of DBS for OCD might be explained. In future, prospective studies should preferably include a standardized neuropsychological assessment battery specifically addressing executive functioning and have a longer-term follow-up in order to demonstrate the cognitive safety of the procedure. Such prospective and more uniform data collection may also contribute to our understanding of the working mechanisms of DBS in OCD.
KW - Cognitive outcome
KW - deep brain stimulation
KW - obsessive compulsive disorder
KW - ELECTRICAL-STIMULATION
KW - NUCLEUS
U2 - 10.1111/ner.13534
DO - 10.1111/ner.13534
M3 - (Systematic) Review article
C2 - 34546638
SN - 1094-7159
VL - 25
SP - 185
EP - 194
JO - Neuromodulation
JF - Neuromodulation
IS - 2
ER -