{"id":2757,"date":"2018-05-14T14:51:54","date_gmt":"2018-05-14T13:51:54","guid":{"rendered":"http:\/\/ocduk.net\/?page_id=2757"},"modified":"2018-07-04T12:46:06","modified_gmt":"2018-07-04T11:46:06","slug":"neurosurgery","status":"publish","type":"page","link":"https:\/\/www.ocduk.org\/overcoming-ocd\/neurosurgery\/","title":{"rendered":"Neurosurgery for the treatment of OCD"},"content":{"rendered":"<p><a href=\"\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-3099 aligncenter\" src=\"\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk.jpg\" alt=\"\" width=\"1200\" height=\"900\" srcset=\"https:\/\/www.ocduk.org\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk.jpg 1200w, https:\/\/www.ocduk.org\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk-300x225.jpg 300w, https:\/\/www.ocduk.org\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk-768x576.jpg 768w, https:\/\/www.ocduk.org\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk-1024x768.jpg 1024w, https:\/\/www.ocduk.org\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk-100x75.jpg 100w, https:\/\/www.ocduk.org\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk-943x707.jpg 943w, https:\/\/www.ocduk.org\/wp-content\/uploads\/2018\/05\/neurosurgery-ocduk-600x450.jpg 600w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><\/a><\/p>\n<p>Over recent years there has been an increase in exploring the use of\u00a0<strong>psychosurgery<\/strong>, sometimes called\u00a0<strong>neurosurgery for mental disorder (NMD)<\/strong>\u00a0or just\u00a0neurosurgery,\u00a0for the treatment of severe treatment refractory OCD. Although the term \u2018treatment refractory\u2019 is a controversial one and not a term OCD-UK like to use.<\/p>\n<p>The <a title=\"NICE Guidelines for the treatment of OCD\" href=\"..\/nice-guidelines-for-the-treatment-of-ocd\/\">NICE Guidelines<\/a> for the treatment of OCD are quite clear, \u00a0neurosurgery is not recommended at this time:<\/p>\n<blockquote  class=\"x-blockquote\" >Neurosurgery is not recommended in the treatment of OCD.<cite class=\"x-cite\">NICE, 2005<\/cite><\/blockquote>\n<p>However, there continues to be some doctors that think neurosurgery should be considered for the most severe treatment resistant cases, where the person\u2019s quality of life is poor.<\/p>\n<p>Whilst we do want to ensure desperate and vulnerable sufferers are helped, there are immense risks associated with surgery, something not all news articles and features on procedures like DBS make clear.\u00a0There is also the question of what is deemed treatment resistant. Just because a patient may have had several courses of psychological treatment without success, that does not take into account the quality of that previous therapy, nor does it mean treatment with an OCD specialist will not be successful in the future.<\/p>\n<p>From the data and reports we have been able to view, the effectiveness of the trials is mixed. Whilst we can\u2019t deny that some people report improved OCD symptoms and make great steps forward in their quality of life, in most cases it\u2019s only to the point of being able to engage in psychological therapy. There has also been reports of relapses in some patients with others reporting no marked difference at all.<\/p>\n<p>Due to these concerns over safety and lack of clear evidence for its effectiveness <strong>at this time OCD-UK do not support the use of neurosurgery in the treatment or research of OCD<\/strong>. However, we will continue to monitor the research data and findings from across the world and we do remain open to adjusting our stance should concerns over safety and effectiveness be allayed in the future.<\/p>\n<h5>Types of Surgery<\/h5>\n<p>Although a variety of different procedures are used, four main ablative procedures have been used in OCD. The procedures can result in permanent lesions in the brain, that are irreversible.<\/p>\n<ul>\n<li>Capsulotomy<\/li>\n<li>Cingulotomy<\/li>\n<li>Subcaudate tractotomy<\/li>\n<li>Limbic leucotomy<\/li>\n<\/ul>\n<p>In addition, there are non-ablative procedures:<\/p>\n<ul>\n<li>Deep Brain Stimulation (DBS)<\/li>\n<li>Vagal Nerve Stimulation (VNS)<\/li>\n<\/ul>\n<p>Deep Brain Stimulation (DBS) has been investigated as a treatment for OCD in recent years across the globe, but so far with limited long-term success, despite media reports to the contrary. It\u2019s claimed that DBS is reversible, but this may not be accurate, with potential risks being serious and long lasting, so we encourage people reviewing\u00a0 DBS as a potential treatment for their OCD to do so with caution. There is also controversy over the effectiveness of DBS for the treatment of depression and OCD, with unsubstantiated claims that not all trials have been published because of poor results.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"titleh5\">What to read next:<\/p>\n<div class=\"x-column x-sm x-1-2\"><span class=\"alignleft\"> <a style=\"outline: none;\" title=\"Back to Medication Side Effects\" href=\"\/overcoming-ocd\/medication\/medication-side-effects\/\"><i class=\"x-icon x-icon-arrow-left\" data-x-icon=\"\uf060\" aria-hidden=\"true\"><\/i> Medication Side Effects<\/a><\/span><\/div>\n<div class=\"x-column x-sm x-1-2 last\"><span class=\"alignright\"><a title=\"Treatment Barriers\" href=\"..\/treatment-barriers\/\">Treatment Barriers <i class=\"x-icon x-icon-arrow-right\" data-x-icon=\"\uf061\" aria-hidden=\"true\"><\/i><\/a><\/span><\/div>\n<hr class=\"x-clear\" \/>\n<hr  class=\"x-gap\" style=\"margin: 20px 0 0 0;\">\n<div id=\"pi-accordion\" class=\"x-accordion\" > <div  class=\"x-accordion-group\" ><div class=\"x-accordion-heading\"><a id=\"tab-6940ea6598d7b\" class=\"x-accordion-toggle collapsed\" role=\"tab\" data-x-toggle=\"collapse-b\" data-x-toggleable=\"6940ea6598d7b\" data-x-toggle-group=\"pi-accordion\" aria-selected=\"false\" aria-expanded=\"false\" aria-controls=\"panel-6940ea6598d7b\"><i class='x-framework-icon x-shortcode-accordion-icon' data-x-icon-s='&#x2b;' aria-hidden=true><\/i><span>Page information and additional reading<\/span><\/a><\/div><div id=\"panel-6940ea6598d7b\" class=\"x-accordion-body x-collapsed\" role=\"tabpanel\" data-x-toggle-collapse=\"1\" data-x-toggleable=\"6940ea6598d7b\" aria-hidden=\"true\" aria-labelledby=\"tab-6940ea6598d7b\"><div class=\"x-accordion-inner\">\n<div  class=\"x-container max width\" >\n<div  class=\"x-column x-sm x-1-2\" style=\"\" >[lastreviewed]<\/div>\n<div  class=\"x-column x-sm x-1-2 last\" style=\"\" > [nextreviewed] <\/div>\n<\/div>\n<hr  class=\"x-gap\" style=\"margin: 20px 0 0 0;\">\n<p class=\"p-medium\"><b>Additional Reading:<\/b><\/p>\n<ul>\n<li>\n<p class=\"p-medium\"><a href=\"https:\/\/www.nice.org.uk\/guidance\/cg31\" target=\"_blank\" rel=\"noopener\">NICE Guidelines for OCD <\/a><span class=\"p-small\">(External Website)<\/span><\/p>\n<\/li>\n<\/ul>\n<hr  class=\"x-gap\" style=\"margin: 20px 0 0 0;\">\n<p class=\"p-small\"><b>Disclaimer:<\/b> This article is for information only and should not be used for the diagnosis or treatment of Obsessive-Compulsive Disorder or any other medical condition. OCD-UK have taken all reasonable care in compiling this information, but always recommend consulting a doctor or other suitably qualified health professional for diagnosis and treatment of Obsessive-Compulsive Disorder or any other medical condition.\n<\/div><\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Over recent years there has been an increase in exploring the use of\u00a0psychosurgery, sometimes called\u00a0neurosurgery for mental disorder (NMD)\u00a0or just\u00a0neurosurgery,\u00a0for the treatment of severe treatment refractory OCD. Although the term \u2018treatment refractory\u2019 is a controversial one and not a term &#8230; <\/p>\n<div><a href=\"https:\/\/www.ocduk.org\/overcoming-ocd\/neurosurgery\/\" class=\"more-link\">Read More<\/a><\/div>\n","protected":false},"author":1,"featured_media":0,"parent":2560,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2757","page","type-page","status-publish","hentry","no-post-thumbnail"],"_links":{"self":[{"href":"https:\/\/www.ocduk.org\/wp-json\/wp\/v2\/pages\/2757","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ocduk.org\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ocduk.org\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ocduk.org\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ocduk.org\/wp-json\/wp\/v2\/comments?post=2757"}],"version-history":[{"count":0,"href":"https:\/\/www.ocduk.org\/wp-json\/wp\/v2\/pages\/2757\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.ocduk.org\/wp-json\/wp\/v2\/pages\/2560"}],"wp:attachment":[{"href":"https:\/\/www.ocduk.org\/wp-json\/wp\/v2\/media?parent=2757"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}