Neurosurgical treatment for refractory obsessive-compulsive disorder: implications for understanding frontal lobe function

J Neuropsychiatry Clin Neurosci. Fall 1994;6(4):467-77. doi: 10.1176/jnp.6.4.467.


A minority of patients with obsessive-compulsive disorder (OCD) have a chronic course and extreme disability, with symptoms refractory to pharmacological and psychological treatment. Considerable uncontrolled evidence suggests such cases may respond to neurosurgical intervention. The authors update current stereotactic procedures and their efficacy, safety, and side effect profiles. The design of an ongoing placebo-controlled trial of Gamma Knife capsulotomy for refractory OCD is outlined. Drug treatment of OCD may be assumed to affect a proposed functional imbalance between the frontal lobes and other parts of the brain. As for neurosurgical treatments, both the effects and side effects may be viewed as expressions of their influence on this functional imbalance.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain Mapping
  • Chronic Disease
  • Double-Blind Method
  • Follow-Up Studies
  • Frontal Lobe / physiopathology*
  • Humans
  • Neural Pathways / physiopathology
  • Neurocognitive Disorders / physiopathology
  • Neurocognitive Disorders / psychology
  • Neurocognitive Disorders / surgery*
  • Obsessive-Compulsive Disorder / physiopathology
  • Obsessive-Compulsive Disorder / psychology
  • Obsessive-Compulsive Disorder / surgery*
  • Postoperative Complications / physiopathology
  • Postoperative Complications / psychology
  • Prospective Studies
  • Psychosurgery*
  • Radiosurgery
  • Treatment Outcome