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Effectiveness and safety of neuroablation for severe and treatment-resistant obsessive-compulsive disorder: a systematic review and meta-analysis
DC Field | Value | Language |
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dc.contributor.author | 장진우 | - |
dc.date.accessioned | 2021-09-29T00:35:21Z | - |
dc.date.available | 2021-09-29T00:35:21Z | - |
dc.date.issued | 2020-09 | - |
dc.identifier.issn | 1180-4882 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/183935 | - |
dc.description.abstract | Background: Several neuroablative procedures are available for severe and treatment-resistant obsessive-compulsive disorder (OCD), but limited knowledge about their relative clinical advantages and disadvantages poses obstacles for treatment decision-making. Methods: We searched PubMed, Embase, Scopus, Web of Knowledge and the Cochrane Library for reports up to February 2019. We reviewed the literature on the effectiveness (assessed using the Yale-Brown Obsessive Compulsive Scale [Y-BOCS]) and safety of various neuroablative interventions for severe and treatment-resistant OCD. Results: We included 23 studies involving 487 patients in the systematic review; 21 studies with 459 patients entered meta-analysis. Overall, neuroablation achieved a response rate (proportion of patients with ≥ 35% reduction in Y-BOCS) of 55%. Most of the adverse events (88.4%) were mild and transient. The top 3 adverse events were headache (14.9%), cognitive deficits (9.1%) and behaviour problems (8.1%). Severe or permanent adverse events included personality changes (2.3%) and brain edema or brain cyst (1.5%). The response rates associated with capsulotomy, limbic leucotomy and cingulotomy were 59% (95% confidence interval [CI] 54-65), 47% (95% CI 23-72) and 36% (95% CI 23-50), respectively. Interventions with different coverages of the dorsal part of the internal capsule were associated with different adverse-event profiles but were unlikely to modify clinical effectiveness. Limitations: The level of evidence of most included studies was relatively low. Conclusion: Ablative surgeries are safe and effective for a large proportion of patients with severe and treatment-resistant OCD. Among the available procedures, capsulotomy seemed to be the most effective. Further research is needed to improve clinical effectiveness and minimize risks. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Canadian Medical Association | - |
dc.relation.isPartOf | JOURNAL OF PSYCHIATRY & NEUROSCIENCE | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Effectiveness and safety of neuroablation for severe and treatment-resistant obsessive-compulsive disorder: a systematic review and meta-analysis | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Neurosurgery (신경외과학교실) | - |
dc.contributor.googleauthor | Yijie Lai | - |
dc.contributor.googleauthor | Tao Wang | - |
dc.contributor.googleauthor | Chencheng Zhang | - |
dc.contributor.googleauthor | Guozhen Lin | - |
dc.contributor.googleauthor | Valerie Voon | - |
dc.contributor.googleauthor | Jinwoo Chang | - |
dc.contributor.googleauthor | Bomin Sun | - |
dc.identifier.doi | 10.1503/jpn.190079 | - |
dc.contributor.localId | A03484 | - |
dc.relation.journalcode | J03565 | - |
dc.identifier.eissn | 1488-2434 | - |
dc.identifier.pmid | 32549057 | - |
dc.contributor.alternativeName | Chang, Jin Woo | - |
dc.contributor.affiliatedAuthor | 장진우 | - |
dc.citation.volume | 45 | - |
dc.citation.number | 5 | - |
dc.citation.startPage | 356 | - |
dc.citation.endPage | 369 | - |
dc.identifier.bibliographicCitation | JOURNAL OF PSYCHIATRY & NEUROSCIENCE, Vol.45(5) : 356-369, 2020-09 | - |
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