title: Suppression of obsessive-compulsive symptoms after epilepsy surgery.
abstract: We report two male patients with medically intractable epilepsy and obsessive-compulsive disorder (OCD) symptoms. Both patients experienced remission of obsessive-compulsive symptoms after surgical treatment of epilepsy. Although the surgeries targeted different brain regions, the two patients had in common unilateral anterior cingulate cortex ablation. On the basis of these observations, we discuss the pathophysiology of OCD symptoms, emphasizing the role of corticosubcortical pathways in their genesis. Our data suggest that surgeries that affect neural loops associated with obsessive-compulsive symptoms can lead to an improvement of OCD; however, the structures responsible for this effect cannot be conclusively determined.
authors.affiliation: Center for Epilepsy Surgery (CIREP), Hospital das Clínicas da FMRP-USP, Ribeirão Preto, SP, Brazil. ricardoguarnieri@uol.com.br
authors.forename: R
authors.initials: R
authors.lastname: Guarnieri
authors.forename: D
authors.initials: D
authors.lastname: Araújo
authors.forename: C G
authors.initials: CG
authors.lastname: Carlotti
authors.forename: J A
authors.initials: JA
authors.lastname: Assirati
authors.forename: J E C
authors.initials: JE
authors.lastname: Hallak
authors.forename: T R
authors.initials: TR
authors.lastname: Velasco
authors.forename: V
authors.initials: V
authors.lastname: Alexandre
authors.forename: V C
authors.initials: VC
authors.lastname: Terra-Bustamante
authors.forename: R
authors.initials: R
authors.lastname: Walz
authors.forename: M M
authors.initials: MM
authors.lastname: Bianchin
authors.forename: L
authors.initials: L
authors.lastname: Wichert-Ana
authors.forename: M
authors.initials: M
authors.lastname: Linhares
authors.forename: C L
authors.initials: CL
authors.lastname: Dalmagro
authors.forename: L M
authors.initials: LM
authors.lastname: Inuzuka
authors.forename: A C
authors.initials: AC
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D003193:Compulsive Personality Disorder / Q000209:etiology*; D004827:Epilepsy / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000503:physiopathology*; D011612:Psychosurgery / Q000379:methods*; D016896:Treatment Outcome