PT  - JOURNAL ARTICLE
AU  - Davidson, Benjamin
AU  - Suresh, Hrishikesh
AU  - Goubran, Maged
AU  - Rabin, Jennifer S.
AU  - Meng, Ying
AU  - Mithani, Karim
AU  - Pople, Christopher B.
AU  - Giacobbe, Peter
AU  - Hamani, Clement
AU  - Lipsman, Nir
TI  - Predicting response to psychiatric surgery: a systematic review of neuroimaging findings
AID  - 10.1503/jpn.190208
DP  - 2020 Nov 01
TA  - Journal of Psychiatry and Neuroscience
PG  - 387--394
VI  - 45
IP  - 6
4099  - http://jpn.ca/content/45/6/387.short
4100  - http://jpn.ca/content/45/6/387.full
SO  - J Psychiatry Neurosci2020 Nov 01; 45
AB  - Background: Psychiatric surgery, including deep brain stimulation and stereotactic ablation, is an important treatment option in severe refractory psychiatric illness. Several large trials have demonstrated response rates of approximately 50%, underscoring the need to identify and select responders preoperatively. Recent advances in neuroimaging have brought this possibility into focus. We systematically reviewed the psychiatric surgery neuroimaging literature to assess the current state of evidence for preoperative imaging predictors of response.Methods: We performed this study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) frameworks, and preregistered it using PROSPERO. We systematically searched the Medline, Embase and Cochrane databases for studies reporting preoperative neuroimaging analyses correlated with clinical outcomes in patients who underwent psychiatric surgery. We recorded and synthesized the methodological details, imaging results and clinical correlations from these studies.Results: After removing duplicates, the search yielded 8388 unique articles, of which 7 met the inclusion criteria. The included articles were published between 2001 and 2018 and reported on the outcomes of 101 unique patients. Of the 6 studies that reported significant findings, all identified clusters of hypermetabolism, hyperconnectivity or increased size in the frontostriatal limbic circuitry.Limitations: The included studies were few and highly varied, spanning 2 decades.Conclusion: Although few studies have analyzed preoperative imaging for predictors of response to psychiatric surgery, we found consistency among the reported results: most studies implicated overactivity in the frontostriatal limbic network as being correlated with clinical response. Larger prospective studies are needed.Registration www.crd.york.ac.uk/prospero/display_record.php?RecordID=131151.