RT Journal Article
SR Electronic
T1 Predicting response to psychiatric surgery: a systematic review of neuroimaging findings
JF Journal of Psychiatry and Neuroscience
JO J Psychiatry Neurosci
FD Canadian Medical Association
SP 387
OP 394
DO 10.1503/jpn.190208
VO 45
IS 6
A1 Davidson, Benjamin
A1 Suresh, Hrishikesh
A1 Goubran, Maged
A1 Rabin, Jennifer S.
A1 Meng, Ying
A1 Mithani, Karim
A1 Pople, Christopher B.
A1 Giacobbe, Peter
A1 Hamani, Clement
A1 Lipsman, Nir
YR 2020
UL http://jpn.ca/content/45/6/387.abstract
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.