Gamma knife radiosurgery versus deep brain stimulation for treatment-refractory depression and obsessive-compulsive disorder: A brief comparative summary

Abstract

Both gamma knife surgery (GKS) and deep brain stimulation (DBS) have documented success in management of treatment-refractory major depressive disorder (MDD) and obsessive-compulsive disorder (OCD), but there are no formal randomized controlled trials to compare these treatment modalities in cases of psychiatric illnesses. In this brief review, comparison of GKS and DBS for management of MDD and OCD was done with regard to their efficacy, accompanying risks, reversibility of therapeutic effects, costs, availability, and daily life issues. Currently available evidence does not support the superiority of either evaluated treatment modality over each other in terms of clinical efficacy in cases of MDD and OCD. Nevertheless, with regard to risks, costs, device maintenance, and daily life issues, GKS definitely seems more advantageous. Reversibility of therapeutic effects of DBS is certainly highly attractive, while may be a bit overhyped. In any case, synergy between GKS and DBS for management of mental illnesses lies in the continuing pursuit of improvement and raising the bar of excellence.

Keywords: Deep brain stimulation; Depression; Gamma knife neurosurgery; Obsessive-compulsive disorder; Psychiatric neurosurgery; Radiosurgery.