Obsessive-Compulsive Disorder: Lesions

  • Adriel Barrios-Anderson
  • Nicole C. R. McLaughlinEmail author


Neuroablative or lesion procedures represent some of the earliest surgical techniques used to treat psychiatric illness. Obsessive-compulsive disorder (OCD) remains one of the psychiatric illnesses most commonly treated with neurosurgery. In the past 50 years, more precise ablative techniques combined with careful patient selection and improved perioperative care have proven efficacious in treating patients with medically refractory OCD. Ablative techniques and functional imaging studies have also begun to uncover the neurobiological mechanisms underlying OCD and have identified cortico-striato-thalamic-cortical (CSTC) neurocircuitry implicated in OCD pathology. The most commonly reported procedures that have been used in modern psychiatric neurosurgical practice for OCD aim to target this pathologic circuitry and include the subcaudate tractotomy, cingulotomy, limbic leucotomy, and capsulotomy. Notably, lesion procedures exhibit similar efficacy to deep brain stimulation (DBS) in treating OCD and in some cases may be a more practical and preferred surgical treatment modality.


Obsessive-compulsive disorder Stereotactic ablation Neuroablation Cingulotomy Capsulotomy Subcaudate tractotomy Limbic leucotomy Psychiatric neurosurgery Functional neurosurgery Lesion procedures 



Anterior cingulate cortex




Deep brain stimulation


Exposure and response prevention


Gamma Knife radiosurgery


Gamma Knife ventral capsulotomy


Major depressive disorder


Magnetic resonance imaging


Obsessive-compulsive disorder


Orbitofrontal cortex


Selective serotonin reuptake inhibitor


Yale-Brown Obsessive Compulsive Scale


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Adriel Barrios-Anderson
    • 1
  • Nicole C. R. McLaughlin
    • 1
    • 2
    Email author
  1. 1.Psychiatric Neurosurgery Program at Butler HospitalProvidenceUSA
  2. 2.Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown UniversityProvidenceUSA

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