OCD behavior therapy before and after gamma ventral capsulotomy: case report.
We report the case of a patient requiring gamma ventral capsulotomy (GVC), a neurosurgical intervention to address severe refractory obsessive-compulsive disorder (OCD). GVC involves stereotactic lesions in the ventral anterior limb of the internal capsule and adjacent ventral striatum. This study details the course of an extinction-based behavioral therapy, namely exposure and response prevention (ERP). The patient experienced significant changes in motivation and ability to tolerate ERP post-surgery. Furthermore, he was better able to absorb and remember exposure sessions. GVC surgery may affect the neural mechanisms involved in the extinction learning process, the same process implicated in ERP treatment.
a Department of Psychiatry and Human Behavior , The Warren Alpert Medical School at Brown University , Providence , RI , USA.
Christopher M
CM
Spofford
Nicole C R
NC
McLaughlin
Fred
F
Penzel
Steven A
SA
Rasmussen
Benjamin D
BD
Greenberg
D000328:Adult; D001521:Behavior Therapy; D003131:Combined Modality Therapy; D005108:Extinction, Psychological; D006801:Humans; D020772:Internal Capsule / Q000601:surgery*; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000601:surgery / Q000628:therapy*; D016634:Radiosurgery; D016896:Treatment Outcome; D055815:Young Adult