Brain surgey is option for patients with OCD

A type of brain surgery appears to be a relatively effective treatment for people with severe obsessive compulsive disorder (OCD) who have not responded to other treatments, a new study suggests.


In the study, nearly half of patients showed at least some improvement in their OCD symptoms, and 15 percent fully recovered seven years after the surgery, Live Science reported.


The findings suggest surgery may be an effective treatment for patients with very severe OCD who have not been helped by other therapies, the researchers said. Patients in the study had not responded to several medications, including serotonin reuptake inhibitors (SRIs) and antipsychotic medications, as well as psychotherapy. On average, patients had experienced symptoms for 16 years, and one-third had attempted suicide.


However, the surgery has significant risks. Two of the 19 patients experienced permanent complications from the surgery, including paralysis on one side of the body and cognitive impairment. Because of this, the procedure should be considered with caution, the researchers said.


Future studies should examine which patients are most likely to be helped by the surgery, so that only those who stand to gain greatest benefit undergo the procedure, the researchers said.


OCD is characterized by recurrent, intrusive thoughts and repetitive behaviors that patients feel compelled to carry out. Patients might perform these behaviors (such as hand washing) for hours, and some are unable to leave their homes. About 20 to 30 percent of patients are not helped by medication or behavioral therapies.


Brain surgery for mental disorders, called psychosurgery, has been practiced since the 1930s, although it is very controversial. Early surgeries, such as lobotomies practiced in the 1940s and 1950s, had serious side effects, including personality changes.


The practice of psychosurgery declined after psychiatric medications became available, although a small number of centers today continue perform psychosurgerical procedures. Today, psychosurgery is much more carefully regulated than it was in the past, and performed only after patients determined to be appropriate candidates for the treatment by a team of psychiatrists and neurologists, said Dr. Michael Schulder, vice chair of neurosurgery at North Shore University Hospital in Manhasset, NY. Brain imaging technology available today helps doctors more carefully select the surgery target, said Schulder, who was not invovled in the new study.