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The aim of this study was to conduct an updated meta\u2010analysis comparing the clinical outcomes of the ablative procedures capsulotomy and cingulotomy and deep brain stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a PubMed search to identify all clinical trials on capsulotomy, cingulotomy, and DBS. Random effects meta\u2010analyses were performed on 38 articles with a primary focus on efficacy in reducing OCD symptoms as measured by a reduction in the Yale\u2010Brown Obsessive\u2010Compulsive Scale (Y\u2010BOCS) score and the responder rate (\u226535% reduction in Y\u2010BOCS score).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>With responder rates of 48% and 53% after 12\u201316\u00a0months and 56% and 57% at last follow\u2010up for ABL and DBS, respectively, and large effect sizes in the reduction in Y\u2010BOCS scores, both surgical modalities show effectiveness in treating refractory OCD. Meta\u2010regression did not show a statistically significant difference between ABL and DBS regarding these outcomes. Regarding adverse events, a statistically significant higher rate of impulsivity is reported in studies on DBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta\u2010analysis shows equal efficacy of ABL and DBS in the treatment of refractory OCD. For now, the choice of intervention should, therefore, rely on factors such as risk of developing impulsivity, patient preferences, and experiences of psychiatrist and neurosurgeon. Future research should provide more insight regarding differences between ABL and DBS and response prediction following direct comparisons between the surgical modalities, to enable personalized and legitimate choices between ABL and DBS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.13276","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T19:55:57Z","timestamp":1611604557000},"page":"307-318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Deep brain stimulation versus ablative surgery for treatment\u2010refractory obsessive\u2010compulsive disorder: A meta\u2010analysis"],"prefix":"10.1111","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3358-5434","authenticated-orcid":false,"given":"Sarah Babette","family":"Hageman","sequence":"first","affiliation":[{"name":"Department of Psychiatry Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geeske","family":"van Rooijen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isidoor O.","family":"Bergfeld","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1700-0958","authenticated-orcid":false,"given":"Frederike","family":"Schirmbeck","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands"},{"name":"Arkin Institute for Mental Health Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pelle","family":"de Koning","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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