Evidence map›Paper›PMID 33144712›Full record

ReviewMolecular psychiatry2021

Deep brain stimulation for refractory obsessive-compulsive disorder (OCD): emerging or established therapy?

Hemmings Wu, Marwan Hariz, Veerle Visser-Vandewalle, Ludvic Zrinzo, Volker A Coenen, Sameer A Sheth, Chris Bervoets, Matilda Naesström, Patric Blomstedt, Terry Coyne and 45 more

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Molecular psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 4 pooled it
5.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 4 syntheses or guidelines pooled it, 113 citations in OpenAlex.

  1. Neuromodulation of the central nervous system for facial pain.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Observational
  6. Article
  7. Article
  8. Review
  9. Review
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

55 authors at 20 institutions in 18 countries.

Hemmings WuDepartment of Neurosurgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Marwan HarizDepartment of Clinical Neuroscience, Umeå University, Umeå, Sweden.
Veerle Visser-VandewalleDepartment of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0002-5274-7929
Ludvic ZrinzoDepartment of Clinical & Motor Neurosciences, UCL Queen Square Institute of Neurology, 33 Queen Square, London, WC1N 3BG, UK.ORCID http://orcid.org/0000-0002-6013-4946
Volker A CoenenDepartment of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Freiburg, Germany.
Sameer A ShethDepartment of Neurological Surgery, Baylor College of Medicine, Houston, TX, USA.
Chris BervoetsAdult Psychiatry, Obsessive Compulsive Disorders Unit, UPC, and Department of Neuroscience, KU Leuven, Leuven, Belgium.
Matilda NaesströmDepartment of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden.
Patric BlomstedtUnit for Deep Brain Stimulation, Umeå University, Umeå, Sweden.
Terry CoyneQueensland Brain Institute, University of Queensland, Brisbane, Australia.
Clement HamaniDivision of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Konstantin SlavinDepartment of Neurosurgery, University of Illinois, Chicago, IL, USA.ORCID http://orcid.org/0000-0002-7946-8639
Joachim K KraussDepartment of Neurosurgery, Medical School Hannover, MHH, Hannover, Germany.ORCID http://orcid.org/0000-0002-0675-9064
Kai G KahlDepartment of Psychiatry, Social Psychiatry, and Psychotherapy, Medical School Hannover, MHH, Hannover, Germany.
Takaomi TairaDepartment of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Chencheng ZhangDepartment of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Bomin SunDepartment of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Hiroki TodaDepartment of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, Osaka, Japan.ORCID http://orcid.org/0000-0002-1596-4131
Thomas SchlaepferDepartment of Interventional Biological Psychiatry, Freiburg University Medical Center, Freiburg, Germany.
Jin Woo ChangDepartment of Neurosurgery and Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Jean RégisAix Marseille University, Inserm UMR1106, Department of Functional and Stereotactic Neurosurgery, Public Assistance Marseille Hospitals, Marseille, France.
Rick SchuurmanDepartment of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands.
Michael SchulderZucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
Paresh DoshiJaslok Hospital and Research Centre, Mumbai, India.
Philip MosleySystems Neuroscience Laboratory, QIMR Berghofer Medical Research Institute, Australia and the Queensland Brain Institute, St Lucia, QLD, Australia.ORCID http://orcid.org/0000-0003-1721-3419
Anujan PoologaindranBrain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, UK.
Gabriel Lázaro-MuñozCenter for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, 77030, USA.ORCID http://orcid.org/0000-0003-1933-9453
Joshua PepperDepartment of Neurosurgery, Queen Elizabeth Hospital, Birmingham, UK.ORCID http://orcid.org/0000-0001-7443-5291
Gaston SchechtmannDepartment of Neurosurgery, Karolinska Institutet and University Hospital, Stockholm, Sweden.
Anders FytagoridisDepartment of Neurosurgery, Karolinska Institutet and University Hospital, Stockholm, Sweden.
Daniel HuysDepartment of Psychiatry and Psychotherapy, University Hospital of Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0002-9124-4128
Antonio Gonçalves-FerreiraUniversity Clinic of Neurosurgery, Faculdade Medicina Lisboa/Hospital Santa Maria, Lisbon, Portugal.
Pierre-François D'HaeseVanderbilt School of Engineering, Nashville, TN, USA.
Joseph NeimatUniversity of Louisville, Louisville, KY, USA.
Giovanni BroggiFond Istituto Neurologico C Besta, Milano, Italy.
Osvaldo Vilela-FilhoStereotactic and Functional Neurosurgery Service, Department of Neurosurgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Brazil.
Jürgen VogesDepartment of Stereotactic Neurosurgery, Otto-von-Guericke University Magdeburg and Leibniz-Institute for Neurobiology, Magdeburg, Germany.
Ahmed AlkhaniDivision of Neurosurgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Takeshi NakajimaDepartment of Neurosurgery, Jichi Medical University, Tochigi, Japan.
Raphaelle RichieriDepartment of Psychiatry, Public Assistance Marseille Hospitals, Marseille, France.
Diana DjurfeldtDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-6772-2214
Philippe FontaineDepartment of Psychiatry, CHC (Centre Hospitalier Chrétien), Liège, Belgium.
Roberto Martinez-AlvarezUnidad de Radiocirugía del Hospital Ruber Internacional de Madrid, Madrid, Spain.
Yasushi OkamuraDepartment of Neurosurgery, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.
Jennifer ChandlerUniversity of Ottawa Centre for Health Law, Policy and Ethics, Ottawa, ON, Canada.
Katsushige WatanabeDepartment of Neurosurgery, Tokyo Metropolitan Matsuzawa Hospital, Kamikitazawa, Setagaya, Tokyo, Japan.
Juan A BarciaDepartment of Neurosurgery, Universidad Complutense de Madrid, Madrid, Spain.
Blanca RenesesInstitute of Psychiatry and Mental Health, Complutense University de Madrid, Madrid, Spain.
Andres LozanoDepartment of Neurosurgery, University of Toronto, Toronto, ON, Canada.
Loes GabriëlsLeo Schreursvest 13, 3001, Heverlee, Belgium.
Antonio De SallesDepartment of Neurosurgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Casey H HalpernDepartment of Neurosurgery, Stanford University Hospital, Stanford, CA, USA.
Keith MatthewsDivision of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, UK.
Joseph J FinsDivision of Medical Ethics, Weill Cornell Medical College and New York Presbyterian Weill Cornell Medical Center, New York, USA.
Bart NuttinDepartment of Neurosurgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium. Bart.Nuttin@uzleuven.be.ORCID http://orcid.org/0000-0003-0439-8215
Umeå University · SEBaylor College of Medicine · USKarolinska University Hospital · SEKU Leuven · BEMedizinische Hochschule Hannover · DEShanghai Jiao Tong University · CNTokyo Metropolitan Matsuzawa Hospital · JPUniversidad Complutense de Madrid · ESUniversity Medical Center Freiburg · DEAmsterdam UMC Location University of Amsterdam · NLAssistance Publique Hôpitaux de Marseille · FRCentre Hospitalier Chrétien · BECornell University · USFondazione IRCCS Istituto Neurologico Carlo Besta · ITHofstra University · USHospital de Santa Maria · PTHospital Ruber Internacional · ESInserm · FRJaslok Hospital · INJichi Medical University · JP

Funding

Neuroethics of aDBS Systems Targeting Neuropsychiatric and Movement DisordersR01MH114854 · NIMH · BAYLOR COLLEGE OF MEDICINE · PI GOODMAN, WAYNE K, LAZARO-MUNOZ, GABRIEL · 2017 to 2020
$2.1M
NIMH NIH HHS R01 MH114854
6 · The paper itself

Abstract

A consensus has yet to emerge whether deep brain stimulation (DBS) for treatment-refractory obsessive-compulsive disorder (OCD) can be considered an established therapy. In 2014, the World Society for Stereotactic and Functional Neurosurgery (WSSFN) published consensus guidelines stating that a therapy becomes established when "at least two blinded randomized controlled clinical trials from two different groups of researchers are published, both reporting an acceptable risk-benefit ratio, at least comparable with other existing therapies. The clinical trials should be on the same brain area for the same psychiatric indication." The authors have now compiled the available evidence to make a clear statement on whether DBS for OCD is established therapy. Two blinded randomized controlled trials have been published, one with level I evidence (Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score improved 37% during stimulation on), the other with level II evidence (25% improvement). A clinical cohort study (N = 70) showed 40% Y-BOCS score improvement during DBS, and a prospective international multi-center study 42% improvement (N = 30). The WSSFN states that electrical stimulation for otherwise treatment refractory OCD using a multipolar electrode implanted in the ventral anterior capsule region (including bed nucleus of stria terminalis and nucleus accumbens) remains investigational. It represents an emerging, but not yet established therapy. A multidisciplinary team involving psychiatrists and neurosurgeons is a prerequisite for such therapy, and the future of surgical treatment of psychiatric patients remains in the realm of the psychiatrist.

Indexed as

Deep Brain StimulationHumansMulticenter Studies as TopicObsessive-Compulsive DisorderRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID33144712
PMCPMC7815503
OpenAlexW3096831886

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.