Neurosurgical Treatment of Obsessive Compulsive Disorder

While many methods have been utilized in the Neurosurgical treatment of OCD , four procedures have evolved as the safest and most effective. These are all performed bilaterally and under stereotactic conditions to allow for precise lesioning of target structures. They include:


1.) Anterior cingulotomy.

2.) Subcaudate tractotomy.

3.) Limbic leucotomy.

4.) Anterior capsulotomy.

Although Talairach was the first to describe anterior capsulotomy, Leksell popularized the procedure for patients with a variety of psychiatric disorders. The aim was to interrupt presumed fronto-thalamic connections in the anterior limb of the internal capsule where they pass between the head of the caudate nucleus and the putamen. Clinical indications for Capsulotomy initially included schizophrenia, depression, chronic anxiety states and obsessional neurosis. Lesions are created by Gamma knife technique .


Obsessive Compulsive Disorder