The newest member of our team, Dr. Sameer A. Sheth from the Epilepsy and Movement Disorders Centers, has published research on a neurosurgical treatment for severe, resistant obsessive-compulsive disorder (OCD). His paper, Limbic system surgery for treatment-refractory obsessive-compulsive disorder: a prospective long-term follow-up of 64 patients, can be found in the March 2013 issue of the Journal of Neurosurgery.
OCD is a psychiatric disorder that affects many people and can be quite debilitating. All too often, the disease is not effectively treated with medications and other traditional behavioral therapies. For over fifty years, a surgical procedure called a cingulotomy has been performed on the brain in these hard-to-treat cases.
The surgery is performed within the brain’s limbic system. Situated deep within the brain, this system is made up of vital structures that control emotion and behavior. Cingulotomy, one of the surgical treatments for OCD, involves the creation of tiny lesions in the cingulate cortex (hence the name “cingulotomy”), one of the components of the limbic system.
Though it has been around for decades, today this procedure is done with incredible precision using sophisticated computers, image guidance technology, and microelectrode recording techniques. The procedure has therefore remained a viable option for patients with such treatment-resistant cases of OCD.
Dr. Sheth and his co-authors at Harvard followed 64 patients with this type of OCD who were treated with cingulotomy from 1989 to 2009 at a single institution. They looked at OCD and depression test results done before surgery and at intervals during an average five year follow-up after surgery. The results were encouraging; both OCD and depression were relieved in a significant number of these patients, leading the authors to conclude:
Limbic system surgery based on initial cingulotomy offers a durable and effective treatment option for appropriately selected patients with severe OCD who have not responded to conventional pharmacotherapy or psychotherapy.
To learn more you can read the article, Limbic system surgery for treatment-refractory obsessive-compulsive disorder: a prospective long-term follow-up of 64 patients, in the March 2013 issue of the Journal of Neurosurgery or read the article online here.
You can also learn more about the newest member of our Columbia Neurosurgery team in our article; Welcome New Columbia Neurosurgeon, Dr. Sameer A. Sheth.
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