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Deep brain stimulation at various locations is approved for the treatment of highly refractory obsessive-compulsive disorder (OCD). Researchers in Brazil examined the benefit of an alternative surgical approach, gamma-knife lesioning of the internal capsule.
The 16 participants had OCD that had failed to respond to multiple serotonin reuptake inhibitors and cognitive-behavior therapy. Patients were randomized to active or simulated bilateral ventral gamma-knife capsulotomy.
During the blinded, first postoperative year, three of eight patients who received active surgery and none in the sham group showed response (≥35% improvement in OCD rating scale scores). Mean OCD-symptom scores were significantly lower in the active-treatment group than i…