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Related Experiment Videos

Neurosurgery for intractable obsessive-compulsive disorder and depression: critical issues.

Benjamin D Greenberg1, Lawrence H Price, Scott L Rauch

  • 1Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA. bdg@butler.org

Neurosurgery Clinics of North America
|July 15, 2003
PubMed
Summary

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Neurosurgery, including lesion procedures and deep brain stimulation, offers potential benefits for intractable obsessive-compulsive disorder (OCD) and depression. Further research is needed to optimize patient selection and treatment protocols for these severe conditions.

Area of Science:

  • Neurosurgery
  • Psychiatry
  • Neurology

Background:

  • Intractable obsessive-compulsive disorder (OCD) and depression cause significant suffering and societal burden.
  • Current treatments offer limited efficacy for a substantial number of patients.
  • Lesion procedures show benefit in 35%-70% of patients, with relatively infrequent serious adverse events.

Purpose of the Study:

  • To review the current literature on neurosurgical interventions for intractable OCD and depression.
  • To identify remaining challenges and future research directions in the field.
  • To provide guidance on referral, patient selection, and postoperative management.

Main Methods:

  • Systematic review of existing literature on lesion procedures and deep brain stimulation for OCD and depression.

Related Experiment Videos

  • Analysis of methodological limitations in previous studies.
  • Discussion of ongoing research and proposed methodologies like randomized controlled trials and sham-controlled studies.

    • Main Results:

    • Neurosurgical procedures demonstrate potential efficacy but face challenges in patient selection and statistical power due to small sample sizes.
    • High rates of comorbid diagnoses and functional impairments in referred patients may influence treatment response.
    • Postoperative management and long-term follow-up are critical but variable factors.

    Conclusions:

    • Despite methodological limitations, neurosurgery offers a viable option for select patients with intractable OCD and depression.
    • Future research should focus on refining patient selection, optimizing procedures, and understanding therapeutic mechanisms.
    • Standardized protocols and cautious advancement are essential for safe and effective psychiatric neurosurgery.