Ablative neurosurgery and deep brain stimulation for obsessive-compulsive disorder.

摘要: Despite advancements in pharmacotherapeutic and behavioral interventions, a substantial proportion of patients with obsessive-compulsive disorder (OCD) continue to have disabling treatment-refractory illness. Neurosurgical including ablative procedures deep brain stimulation (DBS), emerged as potential treatment options this population. We review the recent literature on contemporary surgical for OCD, focusing clinical aspects such patient selection, presurgical assessment, safety effectiveness these procedures. Given invasiveness limited evidence, been performed carefully selected severe, chronic, Along informed consent, an independent by multidisciplinary team is mandated many centers. Both DBS found be helpful around half patients, improvement observed months after procedure. Various targets proposed either procedure, based dominant corticostriatal model OCD. There no strong evidence recommend one procedure over other. Hence, choice often factors affordability, expertise, reversibility adverse effects. Surgery not recommended standalone but should provided part comprehensive package medications psychotherapeutic interventions. Available suggest that benefits outweigh risks Advances neurosurgical techniques increasing knowledge neurobiology are likely bring about further progress efficacy, safety, acceptability