SynthesisMolecular psychiatry2026
Comparative efficacy and safety of different surgical strategies for refractory obsessive-compulsive disorder: evidence from network meta-analysis.
Synthesis in Molecular psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Implantable Neuromodulation Devices in Psychiatry: Human Fidelity and Implementation Challenges.The American journal of psychiatry · 2026Article
- Neural basis of successful DBS for OCD after failed capsulotomy.medRxiv : the preprint server for health sciences · 2026Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectiveTo conduct a network meta-analysis to compare the efficacy and safety of various surgical strategies for refractory obsessive-compulsive disorder (OCD), including ablative surgery (ABL) and deep brain stimulation (DBS), with the aim to guide clinical treatment.
methodsWe searched major electronic databases for different surgical interventions of OCD. The primary outcomes were changes in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at 1 year and at the longest follow-up (LFU); the secondary outcomes included responder rates of Y-BOCS (≥35% reduction) and changes in global function, depression, and anxiety; and the safety outcomes included surgery-related adverse events (SRAEs) and serious adverse events (SAEs).
resultsA total of 75 studies involving 1259 patients and 20 surgical strategies were enrolled. Most interventions resulted in significant improvements in Y-BOCS scores, with a reduction of around 10-15 points. Among them, radiofrequency capsulotomy (RF-Cap, mean difference [MD]: 17.251 at 1 year; MD: 17.458 at LFU) and inferior thalamic peduncle DBS (ITP-DBS, MD: 18.126 at 1 year; MD: 20.209 at LFU) were associated with the greatest improvements. Subthalamic nucleus + ventral capsule/ventral striatum DBS (STN + VC/VS-DBS) also exhibited good efficacy at the LFU (MD: 20.780), although data were lacking at 1 year. In terms of safety, ABL was associated with a higher rate of SRAEs than DBS (26 VS. 22%, p = 0.0325), with mechanical-Cap exhibiting the highest SRAE rate (47.5%). However, both DBS and ABL showed good acceptability, with no significant difference in SAEs.
conclusionBased on the current analysis, RF-Cap and ITP-DBS were associated with the largest improvements; however, the evidence for ITP-DBS is based on a small sample size, and should therefore be interpreted with caution. More head-to-head studies are needed to directly compare different surgical techniques and identify individual treatment options.
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Identifiers
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Registered trials
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 Socratic graph.