{
  "abstract": "Background Psychiatric disorders are increasingly contributing to global disability. Despite advances in conservative management, the prevalence of treatment-resistant cases remains high. Meanwhile, neurosurgery for psychiatric disorders (NPD) remains underused, largely due to strict regulations and historical concerns, particularly those related to neuropsychological side effects (NPSE).Objective To address this issue, we conducted a systematic review with meta-analysis to compare NPSE associated with radiofrequency ablative NPD to those observed in neuro-oncological, neurovascular and epilepsy surgeries.Methods PubMed, Embase and LILACS databases were searched in April 2024 for articles published in English/Spanish from 1990 to 2022, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.Results A total of 48 articles with 2678 participants were included. The frequency of transient and permanent NPSE in the NPD group ranged from 0.94% to 11.50% and 0.94% to 2.03%, respectively, comparable to the other surgical groups (epilepsy: 0.31–11.70%; vascular: 0.52–22.90%; oncology: 0.94–17.60% for transient NPSE; epilepsy: 0.31–12%; vascular: 0.40–1.96% and oncology: 0.84–1.48% for permanent NPSE). Regarding permanent NPSE, arguably the most critical consideration, the NPD group showed better outcomes in memory, language and social cognition than the epilepsy group, but worse outcomes in executive and perceptual-motor functions. Compared with the vascular group, the NPD group had better executive function but worse complex attention. Finally, the NPD group had fewer permanent deficits than the oncology group in executive function, complex attention and perceptual-motor domains, although language performance was lower.Conclusions Contemporary NPD apparently carries a similar risk of NPSE as other conventional neurosurgical procedures, challenging misconceptions and this unjustified barrier to its broader use.",
  "authors": [
    {
      "affiliations": [
        "Division of Neurosurgery, Department of Surgery, Federal University of Goiás Faculty of Medicine, Goiânia, Goiás, Brazil"
      ],
      "name": "Osvaldo Vilela-Filho"
    },
    {
      "affiliations": [
        "Division of Neurosurgery, Department of Surgery, Federal University of Goiás Faculty of Medicine, Goiânia, Goiás, Brazil"
      ],
      "name": "Matheus A Bannach"
    },
    {
      "affiliations": [
        "Division of Neurosurgery, Department of Surgery, Federal University of Goiás Faculty of Medicine, Goiânia, Goiás, Brazil"
      ],
      "name": "Adriano M Lino-Filho"
    },
    {
      "affiliations": [
        "Sunnybrook Research Institute, Toronto, Ontario, Canada"
      ],
      "name": "Clement Hamani"
    },
    {
      "affiliations": [
        "Neurosurgery, KU Leuven, Leuven, Flanders, Belgium"
      ],
      "name": "Bart Nuttin"
    },
    {
      "affiliations": [
        "Clinical Neuroscience/Neurosurgery, Umea University, Umea, Sweden"
      ],
      "name": "Marwan Hariz"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA"
      ],
      "name": "Michael Schulder"
    },
    {
      "affiliations": [
        "Department of Psychiatry & Human Behavior, Brown University, Providence, Rhode Island, USA"
      ],
      "name": "Benjamin David Greenberg"
    },
    {
      "affiliations": [
        "Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Rees Cosgrove"
    },
    {
      "affiliations": [
        "Neurology, D’Or São Luiz Network, Rio de Janeiro, Brazil"
      ],
      "name": "Ricardo De Oliveira-Souza"
    },
    {
      "affiliations": [
        "Institute for Network Stimulation, Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany"
      ],
      "name": "Andreas Horn"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA"
      ],
      "name": "Sameer A Sheth"
    },
    {
      "affiliations": [
        "Center for Neurological Restoration, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"
      ],
      "name": "Cynthia Kubu"
    },
    {
      "affiliations": [
        "Division of Neurosurgery, Department of Surgery, Federal University of Goiás Faculty of Medicine, Goiânia, Goiás, Brazil"
      ],
      "name": "Sherif Salem"
    },
    {
      "affiliations": [
        "Division of Neurosurgery, Department of Surgery, Federal University of Goiás Faculty of Medicine, Goiânia, Goiás, Brazil"
      ],
      "name": "Alice J Zaccariotti"
    },
    {
      "affiliations": [
        "Neuropsychology Unit, Faculty of Education, Federal University of Goiás, Goiânia, Goiás, Brazil"
      ],
      "name": "Naraiana O Tavares"
    },
    {
      "affiliations": [
        "Department of Neurology, State University of Campinas, Campinas, Brazil"
      ],
      "name": "Benito Pereira Damasceno"
    },
    {
      "affiliations": [
        "Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Helen S Mayberg"
    },
    {
      "affiliations": [
        "Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Andres M Lozano"
    },
    {
      "affiliations": [
        "Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine, University of Cologne, Cologne,Germany"
      ],
      "name": "Veerle Visser-Vandewalle"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Cologne, Cologne, Germany"
      ],
      "name": "Jens Kuhn"
    },
    {
      "affiliations": [
        "Clinic for Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany"
      ],
      "name": "Peter Falkai"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA"
      ],
      "name": "Konstantin Slavin"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Jaslok Hospital and Research Centre, Mumbai, India"
      ],
      "name": "Paresh Doshi"
    },
    {
      "affiliations": [
        "Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil"
      ],
      "name": "Antonio C Lopes"
    },
    {
      "affiliations": [
        "Department of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil"
      ],
      "name": "Edoardo FQ Vattimo"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Queensland Brain Institute, Brisbane, Queensland, Australia"
      ],
      "name": "Terry Coyne"
    },
    {
      "affiliations": [
        "Functional Neurosurgery Unit, Queen Square Institute of Neurology, University College London, London, UK"
      ],
      "name": "Harith Akram"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Medical Research Institute Kitano Hospital, Osaka, Japan"
      ],
      "name": "Hiroki Toda"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA"
      ],
      "name": "Casey H Halpern"
    },
    {
      "affiliations": [
        "Stereotactic and Functional Neurosurgery, Neurocenter, Medical Center—University of Freiburg, Freiburg, Germany"
      ],
      "name": "Volker Arndt Coenen"
    },
    {
      "affiliations": [
        "NeuroSapiens®, São Paulo, Brazil"
      ],
      "name": "Alessandra Augusta Gorgulho"
    },
    {
      "affiliations": [
        "Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine, University of Cologne, Cologne,Germany"
      ],
      "name": "Pablo Andrade"
    },
    {
      "affiliations": [
        "Clinical Neuroscience/Neurosurgery, Umea University, Umea, Sweden"
      ],
      "name": "Patric Blomstedt"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, People's Republic of China"
      ],
      "name": "Hemmings Wu"
    },
    {
      "affiliations": [
        "Functional Neurosurgery Unit, Queen Square Institute of Neurology, University College London, London, UK"
      ],
      "name": "Ludvic Zrinzo"
    },
    {
      "affiliations": [
        "Center for Functional Neurosurgery, Shanghai Jiao Tong University Rui Jin Hospital, Shanghai, People's Republic of China"
      ],
      "name": "Bomin Sun"
    },
    {
      "affiliations": [
        "Center for Interventional Psychiatry, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA"
      ],
      "name": "Joao L De Quevedo"
    },
    {
      "affiliations": [
        "Department of Psychiatry, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil"
      ],
      "name": "Paulo Belmonte-De-Abreu"
    },
    {
      "affiliations": [
        "Department of Psychiatry, University of Antwerp, Antwerp, Belgium"
      ],
      "name": "Paul Cosyns"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA"
      ],
      "name": "Nicole Mclaughlin"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia"
      ],
      "name": "Ahmed Alkhani"
    },
    {
      "affiliations": [
        "Department of Neurology, and Neuroethics Studies Program, Georgetown University Medical Center, Washington, DC, USA"
      ],
      "name": "James Giordano"
    },
    {
      "affiliations": [
        "IMPACT Institute, School of Medicine, Deakin University, Geelong, Melbourne, Australia"
      ],
      "name": "Michael Berk"
    },
    {
      "affiliations": [
        "Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Lakshmi N Yatham"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Grenoble Apes University Hospital, University Grenoble Alpes, Grenoble, France"
      ],
      "name": "Stephan Chabardes"
    },
    {
      "affiliations": [
        "Stereotactic Brain Surgery Unit, Department of Surgery, Abulcasis International University of Health Sciences, Rabat, Morocco"
      ],
      "name": "Najia E Abbadi"
    },
    {
      "affiliations": [
        "NeuroSapiens®, São Paulo, Brazil"
      ],
      "name": "Antonio Afonso Ferreira De Salles"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Cape Town, Cape Town, Seoul, South Africa"
      ],
      "name": "Nico Enslin"
    },
    {
      "affiliations": [
        "Department of Psychiatry, Clinics Hospital of Porto Alegre, Porto Alegre, Brazil"
      ],
      "name": "Marcelo B De Sousa"
    },
    {
      "affiliations": [
        "Functional Neurosurgery Unit, AC Camargo Cancer Hospital, São Paulo, Brazil"
      ],
      "name": "José Oswaldo Oliveira, Jr"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Biocor Hospital, Belo Horizonte, Brazil"
      ],
      "name": "Rodrigo Labruna"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Moinho de Ventos Hospital, Porto Alegre, Brazil"
      ],
      "name": "Alexandre Macdonald Reis"
    },
    {
      "affiliations": [
        "Research Division, Hospital Angeles Pedregal, Mexico City, Mexico"
      ],
      "name": "Fiacro Jiménez-Ponce"
    },
    {
      "affiliations": [
        "NeuroSapiens®, São Paulo, Brazil"
      ],
      "name": "Maria A Ferragut"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Korea University Anam Hospital, Seoul, South Korea"
      ],
      "name": "Jin Woo Chang"
    },
    {
      "affiliations": [
        "Neurochirurgie Fonctionnelle et Stéréotaxique, Hôpital d'adulte de la Timone, Aix-Marseille Université, Marseille, France"
      ],
      "name": "Jean Régis"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University Hospital La Princesa, Madrid, Spain"
      ],
      "name": "Cristina V Torres"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, FJK Tokyo Hospital, Tokyo, Japan"
      ],
      "name": "Takaomi Taira"
    },
    {
      "affiliations": [
        "Sunnybrook Research Institute, Toronto, Ontario, Canada"
      ],
      "name": "Nir Lipsman"
    },
    {
      "affiliations": [
        "Servicio de Neurocirugía, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain"
      ],
      "name": "Juan A Barcia"
    },
    {
      "affiliations": [
        "Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA"
      ],
      "name": "Ali Rezai"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, Netherlands"
      ],
      "name": "Rick Schuurman"
    },
    {
      "affiliations": [
        "Department of Functional Neurosurgery and Radiosurgery, Ruber International Hospital, Madrid, Spain"
      ],
      "name": "Roberto Martinez-Alvarez"
    },
    {
      "affiliations": [
        "Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"
      ],
      "name": "Darin D Dougherty"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy"
      ],
      "name": "Giovanni Broggi"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany"
      ],
      "name": "Daniel Huys"
    },
    {
      "affiliations": [
        "Department of Adult Psychiatry, UPCKULEUVEN Psychiatric Hospital, Leuven, Belgium"
      ],
      "name": "Chris Bervoets"
    },
    {
      "affiliations": [
        "Department of Psychiatry, Medical School, Federal University of Goiás, Goiânia, Brazil"
      ],
      "name": "Paulo M Oliveira"
    },
    {
      "affiliations": [
        "Department of Neurology, Goiânia Neurological Institute, Goiânia, Brazil"
      ],
      "name": "Paulo Cesar Ragazzo"
    },
    {
      "affiliations": [
        "Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Peter Giacobbe"
    },
    {
      "affiliations": [
        "Center of Bioethics, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA"
      ],
      "name": "Gabriel Lazaro-Munoz"
    },
    {
      "affiliations": [
        "Grenoble Institut de Neurosciences, Univ. Grenoble Alpes, Inserm U1216, Grenoble, France"
      ],
      "name": "Mircea Polosan"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden"
      ],
      "name": "Matilda Naesström"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden"
      ],
      "name": "Viktoria Johansson"
    },
    {
      "affiliations": [
        "Department of Interventional Biological Psychiatry, Freiburg University Medical Center, Freiburg, Germany"
      ],
      "name": "Thomas Schlaepfer"
    },
    {
      "affiliations": [
        "Neuropsychology Unit, Department of Psychiatry, Goiânia Neurological Institute, Goiânia, Brazil"
      ],
      "name": "Telma MC Ribeiro"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA"
      ],
      "name": "Kendall H Lee"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Medical School, University of Louisville, Louisville, KY, USA"
      ],
      "name": "Joseph S Neimat"
    },
    {
      "affiliations": [
        "Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Mojgan Hodaie"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Federal Medical and Biological Agency, Yalta, Russia"
      ],
      "name": "Andrey Sitnikov"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Istanbul Health and Technology University, Istanbul, Turkey"
      ],
      "name": "Atilla Yilmaz"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia"
      ],
      "name": "Fadi Almahariq"
    },
    {
      "affiliations": [
        "Division of Functional Neurosurgery, Hospital San Vicente Fundacion, Rionegro, Colombia"
      ],
      "name": "Adriana L Lopez Rios"
    },
    {
      "affiliations": [
        "Neurosurgery University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal"
      ],
      "name": "António Gonçalves-Ferreira"
    }
  ],
  "title": "Comparison of neuropsychological side effects between contemporary radiofrequency ablative neurosurgery for psychiatric disorders and conventional neurosurgical procedures: systematic review and meta-analysis",
  "uid": "9397f8ad-a5a8-57da-9286-9f8febd401a6"
}