I am looking for the very latest research on neuro-surgery for intractable OCD. Is there a developing consensus vis-a-vis this issue, or are the discussions still at a very early stage?
Clinical trials using Magnetic Resonance guided Focused Ultrasound (MRgFUS) to perform bilateral lesioning of the anterior limb of the internal capsule have been performed in Korea and are on their way in Canada and the US.
For intractable OCD , neurourgeons are providing functional neurosurgical intervention, which is encouraging but needs to follow rigrous patient selection criteria and appropriate experties of surgical team.
I do not think current guideline would recommend surgical intervention for OCDs, even there had been several scatted cases reported in clinical conferences I attended some time ago, they mostly emphasized on the functional neurosurgical approaches themselves, instead of being very specific targeting the diseases.
My personal point of view, functional neurosurgery should be the last resort due to its invasive nature. So I would still tend to recommend aggressive dosage medication for the treatment effect even though it means the burden to live with relevant drug induced adverse effects, over surgical intervention for this kind of patients.
Many thanks for this very insightful reply Junjie. I found the weighing up of invasive surgery versus - so to speak - relevant drug induced effects to be an excellent start to further conversations with you and with other researchers.
Transcutaneous Vagus Nerve Stimulation (tVNS) offers a noninvasive method of Neuromodulation. Thus, you may wish to research this possibility.
Dear Enrique
I shall explore this very important lead, and I thank you for your expert guidance. Kind regards. Paul
Dear Prof V:
I hope you are doing well.
There are few papers on this tVNS stimulation.
I added this recent paper, and I exploring these procedure once approved in the KSA.
best regards,
Thanks Saleh,
tVNS is an excellent non invasive method of Neuromodulation available to treat a variety of conditions keeping in mind that the effects of stimulation could take several weeks to set in.
Kind regards,
EV
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