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In 2014, the World Society for Stereotactic and Functional Neurosurgery (WSSFN) published consensus guidelines stating that a therapy becomes established when \u201cat least two blinded randomized controlled clinical trials from two different groups of researchers are published, both reporting an acceptable risk-benefit ratio, at least comparable with other existing therapies. The clinical trials should be on the same brain area for the same psychiatric indication.\u201d The authors have now compiled the available evidence to make a clear statement on whether DBS for OCD is established therapy. Two blinded randomized controlled trials have been published, one with level I evidence (Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score improved 37% during stimulation on), the other with level II evidence (25% improvement). A clinical cohort study (<jats:italic>N<\/jats:italic>\u2009=\u200970) showed 40% Y-BOCS score improvement during DBS, and a prospective international multi-center study 42% improvement (<jats:italic>N<\/jats:italic>\u2009=\u200930). The WSSFN states that electrical stimulation for otherwise treatment refractory OCD using a multipolar electrode implanted in the ventral anterior capsule region (including bed nucleus of stria terminalis and nucleus accumbens) remains investigational. It represents an emerging, but not yet established therapy. A multidisciplinary team involving psychiatrists and neurosurgeons is a prerequisite for such therapy, and the future of surgical treatment of psychiatric patients remains in the realm of the psychiatrist.<\/jats:p>","DOI":"10.1038\/s41380-020-00933-x","type":"journal-article","created":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T15:02:41Z","timestamp":1604415761000},"page":"60-65","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":121,"title":["Deep brain stimulation for refractory obsessive-compulsive disorder (OCD): emerging or established 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VV-V has received honoraria from Boston Scientific and Aleva for giving presentations and advice. LZ has acted as Consultant and received travel expenses and honoraria for educational activities from Medtronic, Boston Scientific and Elekta. VAC is a consultant for CORTICS, Munich and CorTec, Freiburg. He receives an ongoing grant from BrainLab, Munich; he has received honoraria and travel support for talks from Brainlab, Munich and Boston Scientific, USA. He receives support from Medtronic, USA and Boston Scientific, USA for IITs. SAS is consulting for Medtronic, Boston Scientific, NeuroPace, and Koh Young. MN received travel expenses by Medtronic for attending a DBS OCD-course. PB is a consultant for Abbott, Boston Scientific & Medtronic, and a shareholder in Mithridaticum AB. His research is supported by the Swedish Research Council. TC is involved in clinical trials of DBS for refractory OCD and anorexia nervosa, where the devices have been donated by Medtronic & Boston Scientific, respectively, but with the trials otherwise entirely independent of these companies, who have no rights to data or editorial input. KS is a consultant and received honoraria and\/or research support from the following companies: Abbott, Medtronic, Boston Scientific, Nuvectra, Nevro, Neuros, ATI, Stimwave. JKK is a consultant to Medtronic and Boston Scientific. Chencheng Zhang has received honoraria and travel expenses from the Deep Brain Stimulation industry (Medtronic, PINS, SceneRay). BS received research support from PINS and SceneRay (donated devices). JR has acted as Consultant and received travel expenses and honoraria for educational activities from Medtronic, Boston Scientific and Elekta. RS is consultant to Boston Scientific, Elekta and Medtronic for educational activities. PM receives honorarium from Boston Scientific for speaking at an educational meeting and unrestricted educational grant from Medtronic. He is a principal investigator in trials of DBS for OCD and Anorexia Nervosa. GS receives research and travel grants from Medtronic and travel grants from Boston Scientific. AG-F is a member of the Medtronic Steering Committee for the MORE Registry study (ANT-DSBS for epilepsy). OV-F has received honoraria for educational activities from Medtronic and travel grants from the local representative of Abbott. LG was principal investigator of the OCD-PMCF trial, sponsored by Medtronic, and received consultancy fees from Medtronic. CHH has received speaking honoraria and consulting fees from Medtronic, Boston Scientific, and NeuroPace. KM has chaired advisory boards for studies of deep brain stimulation for OCD sponsored by Medtronic; has received unrestricted educational awards from Cyberonics Inc and Abbott (previously St Jude Medical), and has received travel and accommodation support to attend meetings from Medtronic and Abbott. BN is last author in Luyten et al. []. This work was supported by the Research Foundation\u2014Flanders (FWO) Project G072909N, FWO Research Grant (to LL) 1504614N. All devices in the paper Luyten et al. [], were generously provided by Medtronic. Medtronic also provided grants for research, education and traveling. He held the Medtronic Chair for Stereotactic Neurosurgery in Psychiatric Disorders at KU Leuven as well as a Chair for Neuromodulation, an endowment from Medtronic. BN co-owns a patent on DBS in OCD. The rest of the authors declare that there is no conflict of interest regarding the work described in this paper.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}