Скачать или смотреть Modern Neurosurgical Approaches in Treatment-Resistant OCD: From Lesioning to Neuromodulation

This talk explores current neurosurgical interventions for severe, treatment-resistant obsessive-compulsive disorder, focusing on treatments available through specialist NHS centres and approved by NICE. We'll examine how our understanding of OCD circuits, particularly the cortico-striato-thalamo-cortical pathway, has evolved through neuroimaging advances at leading UK research institutions.

Three main surgical approaches will be discussed: stereotactic ablative procedures like anterior capsulotomy, deep brain stimulation (DBS) targeting the ventral capsule/ventral striatum region, and the emerging role of focused ultrasound. These procedures are typically considered only after patients have undergone CBT and tried at least two SSRIs via NHS pathways.

Recent long-term outcome data from British and European centres shows that 60-70% of carefully selected patients achieve meaningful symptom reduction. While traditional ablative procedures remain relevant within the NHS framework, DBS offers the advantage of adjustability and reversibility. We'll address patient selection criteria through MDT assessment, ethical considerations within UK healthcare guidelines, and the collaborative approach between psychiatry and neurosurgery.

The talk concludes by examining how emerging technologies might enhance NHS treatment protocols in future years.