People who are suffering from severe obsessive-compulsive disorder (OCD), may benefit from radiosurgery when other treatments have failed, finds a new study.
Dr Douglas Kondziolka and colleagues of University of Pittsburgh reported promising results of radiosurgery in three patients with very severe, 'medically refractory' OCD.
Although further research was needed, the procedure could provide a new treatment alternative for the most extreme and difficult cases of OCD.
The patients were two women and a man with extremely severe OCD - on a standard OCD severity scale, two of the patients scored 39 out of 40.
Despite taking multiple medications, all patients continued to have severe and disabling OCD symptoms.
Tired of all other treatment options, the three patients underwent radiosurgery.
In this procedure, a piece of equipment called a 'gamma knife' is used to deliver an intense beam of radiation targeted precisely to the area of the brain (the anterior cingulate cortex) responsible for OCD symptoms.
The experimental procedure was tried only after careful evaluation. In addition to meeting criteria for extreme OCD, the patients had to request radiosurgery, and the procedure had to be recommended by at least two psychiatrists.
All radiosurgery procedures were performed without complications; the patients were followed for up to 41/2 years.
"All patients noted significant functional improvements and reduction in OCD behavior," said Kondizolka.
The improvements occurred gradually, typically peaking between two and four months. All patients had to continue taking medications. One patient's OCD symptoms began to worsen again when he stopped taking medications.
Although preliminary, the new results suggested that radiosurgery could offer a valuable new option for those most severe cases of OCD.
Radiosurgery has some potential disadvantages also - the procedure is irreversible and doesn't allow adjustment of stimulation patterns.
Kondizolka said much more research would be required before radiosurgery could be widely recommended for patients with severe OCD.
The study is published in the January issue of Neurosurgery.