Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Deep Brain Stimulations for Obsessive-Compulsive Disorder: Update of the 2014 Guidelines.
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Deep Brain Stimulations for Obsessive-Compulsive Disorder: Update of the 2014 Guidelines.
复制标题
神经外科医生大会强迫症深部脑刺激系统审查和循证指南：2014 年指南更新。
DOI：
10.1093/neuros/nyaa596
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发表时间：
2021
期刊：
影响因子：
4.8
通讯作者：
Pilitsis,JulieG
中科院分区：
文献类型：
--
作者：
Staudt,MichaelD;Pouratian,Nader;Miller,JonathanP;Hamani,Clement;Raviv,Nataly;McKhann,GuyM;Gonzalez-Martinez,JorgeA;Pilitsis,JulieG
背景2020年，指南工作组再次对深部脑刺激（DBS）治疗强迫症（OCD）相关文献进行系统回顾，更新原2014年指南，确保临床实践的及时性和准确性。 目的对文献进行系统回顾，更新DBS治疗强迫症（OCD）循证指南。方法指南工作组对相关文献进行再次系统回顾，检索术语和策略与检索相同。 PubMed 和 Embase 获取相关文献。更新后的检索包括 1966 年至 2019 年 12 月期间发表的研究。还应用了与原始指南相同的纳入/排除标准。对摘要进行了审查，并对相关全文文章进行了检索和评分。在 864 篇文章中，检索了 10 篇进行全文审查和分析。根据本次更新产生的新证据更新了建议。结果 原始指南中包含了七项研究，报告使用双侧 DBS 比假治疗更能有效改善强迫症症状。本次更新还纳入了另外 10 项研究：1 项 II 类研究和 9 项 III 类研究。结论根据文献中发表的数据，可以提出以下建议：（1）建议临床医生使用双侧丘脑底核 DBS 来治疗医学难治性 OCD（I 级）患者。（2）临床医生可以使用双侧伏隔核或终纹床核 DBS 来治疗医学上难治性 OCD 患者。难治性强迫症（II级）。没有足够的证据来提出确定最有效目标的建议。
BACKGROUNDIn 2020, the Guidelines Task Force conducted another systematic review of the relevant literature on deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) to update the original 2014 guidelines to ensure timeliness and accuracy for clinical practice.OBJECTIVETo conduct a systematic review of the literature and update the evidence-based guidelines on DBS for OCD.METHODSThe Guidelines Task Force conducted another systematic review of the relevant literature, using the same search terms and strategies as used to search PubMed and Embase for relevant literature. The updated search included studies published between 1966 and December 2019. The same inclusion/exclusion criteria as the original guideline were also applied. Abstracts were reviewed and relevant full-text articles were retrieved and graded. Of 864 articles, 10 were retrieved for full-text review and analysis. Recommendations were updated according to new evidence yielded by this update.RESULTSSeven studies were included in the original guideline, reporting the use of bilateral DBS as more effective in improving OCD symptoms than sham treatment. An additional 10 studies were included in this update: 1 class II and 9 class III.CONCLUSIONBased on the data published in the literature, the following recommendations can be made:(1) It is recommended that clinicians utilize bilateral subthalamic nucleus DBS over best medical management for the treatment of patients with medically refractory OCD (level I).(2) Clinicians may use bilateral nucleus accumbens or bed nucleus of stria terminalis DBS for the treatment of patients with medically refractory OCD (level II). There is insufficient evidence to make a recommendation for the identification of the most effective target.