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<p>Obsessive–compulsive disorder (OCD) is a chronic and disabling condition for which neuromodulation has emerged as a key therapeutic strategy for severe cases. This systematic review and meta-analysis evaluated invasive and non-invasive neuromodulation for OCD using studies identified from PubMed, Embase and Cochrane (inception to December 2024) that reported pre- and post-treatment severity scores in at least two patients. We assessed risk of bias, estimated pooled mean differences (MD) using random-effects models and investigated stimulation targets using network analysis. Across 142 studies (<i>n</i> = 2,960), neuromodulation reduced symptoms by 35.3% (95% confidence interval (CI) 32.6–38.0). Invasive interventions showed the largest effects (MD 39.7–45.1), whereas non-invasive modalities yielded more modest benefits (MD 26.4–28.8). Sham-controlled (MD 15.4, 95% CI 10.9–20.0) and low-bias analyses (MD 10.7, 95% CI 5.5–16.0) confirmed efficacy beyond placebo. These findings demonstrate robust symptom improvement with neuromodulation, with invasive approaches yielding the greatest benefit.</p>

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Neuromodulation for treatment-resistant obsessive–compulsive disorder: a systematic review, meta-analysis and network analysis

  • 期刊论文

  • 发表日期：

    2026年4月13日

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  • Flavia Venetucci Gouveia,
  • Gavin J. B. Elias,
  • Emily H. Y. Wong,
  • Andrew Yang,
  • Michelle Beyn,
  • Amelia Mesich,
  • Uyiosa Omere,
  • Sarah A. Iskin,
  • Yutong Bai,
  • Chao-Kai Hu,
  • Alexandre Boutet,
  • Andres M. Lozano,
  • Jürgen Germann

摘要

Obsessive–compulsive disorder (OCD) is a chronic and disabling condition for which neuromodulation has emerged as a key therapeutic strategy for severe cases. This systematic review and meta-analysis evaluated invasive and non-invasive neuromodulation for OCD using studies identified from PubMed, Embase and Cochrane (inception to December 2024) that reported pre- and post-treatment severity scores in at least two patients. We assessed risk of bias, estimated pooled mean differences (MD) using random-effects models and investigated stimulation targets using network analysis. Across 142 studies (n = 2,960), neuromodulation reduced symptoms by 35.3% (95% confidence interval (CI) 32.6–38.0). Invasive interventions showed the largest effects (MD 39.7–45.1), whereas non-invasive modalities yielded more modest benefits (MD 26.4–28.8). Sham-controlled (MD 15.4, 95% CI 10.9–20.0) and low-bias analyses (MD 10.7, 95% CI 5.5–16.0) confirmed efficacy beyond placebo. These findings demonstrate robust symptom improvement with neuromodulation, with invasive approaches yielding the greatest benefit.