Systematic Reviews
Copyright ©The Author(s) 2021.
World J Psychiatr. Sep 19, 2021; 11(9): 659-680
Published online Sep 19, 2021. doi: 10.5498/wjp.v11.i9.659
Table 1 Risk of bias for randomized controlled trials
Ref.Random sequence generationAllocation concealmentBlinding of participants and personnelBlinding of outcome assessmentIncomplete outcome dataSelective reportingOther bias
Abelson et al[67], 2005--+
Barcia et al[32], 2019+---
Goodman et al[16], 2010--+
Huff et al[31], 2010+
Luyten et al[20], 2016+--
Tyagi et al[17], 2019+++
Welter et al[39], 2020+---
Table 2 Risk of bias for non-randomized controlled trials
Ref.SelectionComparabilityOutcome
Anderson and Ahmed[74], 2003+++++
Aouizerate et al[75], 2009++++++
Azriel et al[76], 2020++++++
Chabardes et al[29], 2020+++++
Chang et al[77], 2017++++++
Choudhury et al[78], 2017++++++
Coenen et al[79], 2017++++++
Denys et al[44], 2020+++++
Doshi et al[80], 2019++++++
Farrand et al[42], 2018++++++
Fayad et al[33], 2016++++++
Franzini et al[81], 2010+++++++
Gabriëls et al[53], 2003++++++
Graat et al[19], 2020++++++
Grant et al[34], 2016++++++
Greenberg et al[36], 2010++++++
Gupta et al[35], 2019++++++
Holland et al[21], 2020++++
Huys et al[30], 2019++++++
Islam et al[40], 2015++++++
Jiménez et al[55], 2013++++++
Lee et al[37], 2019++++++
Maarouf et al[45], 2016++++++
Mallet et al[22], 2019++++++
Menchón et al[13], 2021+++++
Mulders et al[82], 2017++++++
Plewnia et al[83], 2008++++++
Polosan et al[38], 2019++++++
Roh et al[61], 2012++++++
Sachdev et al[84], 2012+++++
Senova et al[85], 2020++++++
Tsai et al[49], 2012+++++
Winter et al[28], 2021++++++
Table 3 Differences in mean characteristics between the short-term and long-term studies
CharacteristicShort-term
Long-term
mean ± SD
Range
mean ± SD
Range
Sample size, n7.9 ± 13.61-7014 ± 14.41-50
Female, %54 ± 36.90-10061.5 ± 2233-100
Average age, yr41.7 ± 9.928-7240.5 ± 4.332-45
Average duration of illness, yr24 ± 16.45-5220.4 ± 3.216-25
Follow-up since DBS, mo18.5 ± 87-3663.7 ± 20.738-96
Follow-up since DBS, yr1.5 ± 0.61-2.75.3 ± 1.73-7.7
Baseline Y-BOCS, mean score33 ± 3.719-3934.4 ± 1.732-38
Last Y-BOCS, mean score17.2 ± 7.41-3118 ± 3.211-21
Y-BOCS improvement, %47.4 ± 2110-9747.2 ± 9.936-71
Responders, %60.6 ± 36.20-10070.7 ± 24.822-100
Yes/noYes/no
RCT6/231/10
Depression assessment21/69/11
Depression improvement15/48/1
Functionality assessment16/137/4
Functionality improvement14/17/0
Table 4 Participant characteristics in the short-term studies
Ref.nFemale %Average age (yr)Average duration of illness (yr)Average follow-up since DBS implantation (mo)Target site
RCTAbelson et al[67], 200545040.222.512.8ALIC
Barcia et al[32], 2019757.135.225.321NAcc/CN
Goodman et al[16], 201066636.22412VC/VS
Huff et al[31], 2010104036.322.212NAcc
Tyagi et al[17], 2019616.645.524.112VC/VS, STN, VC/VS/STN
Welter et al[39], 2020812.542.5NR22STN, CN, NAcc
Non-RCTAnderson and Ahmed[74], 20031100351010ALIC
Aouizerate et al[75], 2009205133.515NAcc/CN
Azriel et al[76], 20201100674416amGPI
Chabardes et al[29], 20201963.13920.724STN
Chang et al[77], 2017110028812VC/VS
Coenen et al[79], 20172041.52912MFB
Denys et al[44], 2020706941.72512ALIC
Doshi et al[80], 2019110042NR12NAcc
Farrand et al[42], 2018757.1462531NAcc or BNST
Franzini et al[81], 2010203721.525.5NAcc
Gabriëls et al[53], 200336741.724.327NAcc/ALIC
Grant et al[34], 20161030536NAcc
Huys et al[30], 2019205040.126.112ALIC-NAcc
Islam et al[40], 201581745.830.225BNST, NAcc
Jiménez et al[55], 201365034.716.224ITP
Maarouf et al[45], 201647539.323.511.5MD/VA
Menchón et al[13], 202129524124.512ALIC
Mulders et al[82], 20171100493424VC/VS
Plewnia et al[83], 2008110051NR24ALIC/NAcc
Roh et al[61], 201242545.524.224VC/VS
Sachdev et al[84], 2012110032287NAcc
Senova et al[85], 20201100725236STN
Tsai et al[49], 20124025.58.315VC/VS
Table 5 Participant characteristics in the long-term studies
Ref.nFemale %Average age (yr)Average duration of illness (yr)Average follow-up since DBS implantation (mo)Target site
RCTLuyten et al[20], 2016245039NR77ALIC/BST
Non-RCTChoudhury et al[78], 20171100452151ALIC
Fayad et al[33], 201666644.5NR92.5VC/VS
Graat et al[19], 2020506841.625.281.6ALIC
Gupta et al[35], 2019210046.52342VC/VS/ ALIC
Greenberg et al[36], 2010264635.32296VC/VS
Holland et al[21], 2020944.440.2NR54.8VC/VS
Lee et al[37], 201956032.416.249.8ITP
Mallet et al[22], 20191442.843.8NA46STN
Polosan et al[38], 2019126738.31838STN
Winter et al[28], 2021633.339.61872ALIC/BNST
Table 6 Summary of results for the short-term studies
Ref.Average baseline Y-BOCSAverage Y-BOCS at LFUAverage Y-BOCS improvement (%)Average responders (%)Depression (HDRS, BDI, MADRS, DASS, POMS)Depression scale improvementGlobal functionality (GAF, CGIS, SOFAS)Functionality improvement
RCTAbelson et al[67], 200532.7233050Yes, HDRSYesNR NR
Barcia et al[32], 201932.215.45185.7Yes, HDRS and BDINoNRNR
Goodman et al[16], 201033.7184667Yes, HDRSYesYes, CGISSYes
Abelson et al[67], 200532.325.4218.3Yes, HDRS and BDIYesYes, GAFYes
Barcia et al[32], 201936.114.161NRYes, MADRSYesNRNR
Goodman et al[16], 201033.523.23037.5Yes, MADRSNoNRNR
Non-RCTAnderson and Ahmed[74], 200334197100NRNRYes, GAFYes
Aouizerate et al[75], 2009251156100Yes, HDRSYesNRNR
Azriel et al[76], 2020331648100NRNRNRNR
Chabardes et al[29], 202033.315.85373NRNRYes, GAFYes
Chang et al[77], 20173625300Yes, HDRSNRYes, GAFYes
Coenen et al[79], 20173020.53150Yes, BDIYesYes, GAFNR
Denys et al[44], 202033.720.24052Yes, HDRSYesNRNR
Doshi et al[80], 201919573.7100Yes, HDRSYesNRNR
Farrand et al[42], 201832.8242642.8Yes, DASS-DYes Yes, SOFASYes
Franzini et al[81], 201034204150Yes, HDRSYesYes, GAFYes
Gabriëls et al[53], 200333.62137.566.6Yes, POMSNoNRNR
Grant et al[34], 201632971100NRNRNRNR
Huys et al[30], 201930.920.73340Yes, BDINoYes, GAFYes
Islam et al[40], 201535.320.84150Yes, HDRSNRYes, GAFNR
Jiménez et al[55], 201335.815.556100NRNRYes, GAFYes
Maarouf et al[45], 201634.731100Yes, BDINRYes, GAFNo
Menchón et al[13], 202134.7204260Yes, MADRSYesYes, GAFYes
Mulders et al[82], 2017341748100NRNRNRNR
Plewnia et al[83], 20083124250NRNRYes, GAFYes
Roh et al[61], 20123814.859.7100Yes, HDRSNRYes, GAFYes
Sachdev et al[84], 201239587.1100NRNRNRNR
Senova et al[85], 202031196100Yes, MADRSYesNRNR
Tsai et al[49], 201236.32433.825Yes, HDRSYesYes, GAFYes
Table 7 Summary of results for the long-term studies
Ref.Average baseline Y-BOCSAverage Y-BOCS at LFUAverage Y-BOCS improvement (%)Average responders (%)Depression (HDRS, BDI, MADRS, QIDS, IDS-30)Depression scale improvementGlobal buncionality (GAF, IADL, SF-36)Functionality improvement
RCTLuyten et al[20], 20163519.34567Yes, HDRSYesYes, GAFYes
Non-RCTChoudhury et al[78], 2017372143100Yes, BDIYesYes, IADLYes
Fayad et al[33], 201633.615.15566Yes, HDRSNoYes, SF-36Yes
Graat et al[19], 202033.320.53950Yes, HDRSYesYes, GAFYes
Gupta et al[35], 2019381171100Yes, BDIYesNRNR
Greenberg et al[36], 20103421.53661Yes, HDRSYesYes, GAFYes
Holland et al[21], 202034.520.740.322Yes, HDRS, MADRS, QIDS, IDS-30 and BDIYesYes, GAFNR
Lee et al[37], 2019351654100Yes, HDRSYesNRNR
Mallet et al[22], 201932.415.45075Yes, BDIYesYes, GAFYes
Polosan et al[38], 201934.32041NRNRNRNRNR
Winter et al[28], 202132.117.74566Yes, BDIYesNRNR