Clinical efficacy of deep brain stimulation for psychiatric and neurological indications on a meta-analytic level.
Victoria Froschauer, Johan Saelens, Anna Gramser et al.
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In 30 seconds
This meta-analysis compared active with sham deep brain stimulation (DBS) in 28 blinded randomised controlled trials across psychiatric and neurological indications. Among psychiatric indications, DBS was associated with a significant effect in obsessive-compulsive disorder (OCD; SMD −0.72, p = .004) and Gilles-de-la-Tourette syndrome (GTS; SMD −1.22, p = .014), but not major depressive disorder. The largest reported effect was in GTS; among neurological indications, it was in essential tremor (ET; SMD −1.42, p = .0003). The authors conclude that broader clinical use in OCD and GTS is justifiable.
Key findings
- OCD showed an SMD of −0.72 (p = .004), while major depressive disorder showed an SMD of −0.22 (p = .204).
- GTS had the largest psychiatric effect size (SMD −1.22, p = .014).
- ET had the largest neurological effect size (SMD −1.42, p = .0003); effects were also reported for Parkinson’s disease and dystonia.
- Epilepsy showed an SMD of −0.09 (p = .790), with no statistically significant effect reported.
Why it matters
The findings distinguish indications where blinded trial evidence showed measurable DBS effects from those where it did not. This may help frame clinical discussions and research priorities across psychiatric and neurological uses, while the authors’ conclusion about broader use in OCD and GTS should be considered alongside the smaller evidence base for psychiatric DBS.
What to keep in mind
The abstract notes that psychiatric DBS studies included substantially fewer patients. The analysis also draws on a limited set of 28 trials across several distinct indications.