It is estimated that 40% to 60% of patients with obsessive-compulsive disorder (OCD) continue to experience symptoms despite adequate medical treatment.
For treatment-refractory patients, promising results have been reported with the use of deep brain stimulation (DBS).
Based on the data published in the literature, the following recommendations can be made:
(1) There is Level of evidence 1, based on a single class 1 study, for the use of bilateral subthalamic deep brain stimulation for the treatment of medically refractory OCD.
(2) There is Level of evidence 2, based on a single class 2 study, for the use of bilateral nucleus accumbens DBS for the treatment of medically refractory OCD.
(3) There is insufficient evidence to make a recommendation for the use of unilateral DBS for the treatment of medically refractory OCD 1).
1) Hamani C, Pilitsis J, Rughani AI, Rosenow JM, Patil PG, Slavin KS, Abosch A, Eskandar E, Mitchell LS, Kalkanis S. Deep Brain Stimulation for Obsessive-Compulsive Disorder: Systematic Review and Evidence-Based Guideline Sponsored by the American Society for Stereotactic and Functional Neurosurgery and the Congress of Neurological Surgeons (CNS) and Endorsed by the CNS and American Association of Neurological Surgeons. Neurosurgery. 2014 Oct;75(4):327-333. PubMed PMID: 25050579.