LAUSR

BACKGROUND Obsessive-compulsive disorder (OCD) is a chronic disease with a lifetime prevalence of 3%, and is associated with severe impairment in familial and socio-occupational functioning. Gamma ventral capsulotomy (GVC) is a treatment choice in carefully chosen patients with few published reports. In this study, we aimed to report the efficacy and safety of GVC in 21 patients with treatment-resistant OCD. METHODS This is a retrospective, single-center study. Twenty-one patients meeting the selection criteria were included. Patients were considered responders if there were ≥35% reduction in post-GVC Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores and considered in remission if scores were ≤8. The mean and median clinical follow-up durations were 60.7 and 56 months, respectively (range, 38-149 months). RESULTS The mean baseline Y-BOCS score of 35.7 (n=21) decreased to 15.3 (n=20) at 36th-month follow-up evaluation (p<0.0001). Fifteen patients (75%) achieved a full response. Of those, seven patients (35%) were considered to be in remission. There were no partial responders, and five patients (25%) were classified as non-responders. The pre-GVC mean BDI score of 35.1 (n=21) decreased to 13.8 (n=20) at 36th-month follow-up evaluation (p<0.0001). Three patients (14.3%) had a transient post-GVC headache that resolved within a week, and two patients (9.5%) had persistent headaches that responded to 2-week oral corticosteroid treatment. A brain cyst developed after GVC in two patients (10%). No clinically notable abnormalities were seen on neurologic examination at any follow-up. CONCLUSIONS Gamma ventral capsulotomy is a reasonable treatment method in select patients with treatment-resistant OCD.