Gamma Knife Snips OCD in Bud

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May 8, 2008 (Washington) — A high-tech procedure that delivers radiationdeep within the brain relieved symptoms in half of patients withobsessive-compulsive disorder who got no help from medication or talk therapy, asmall study shows.

The procedure uses a gamma knife to target brain circuits that work overtimein people with obsessive-compulsive disorder (OCD), says Antonio Lopes, MD,PhD, of the University of Sao Paulo in Brazil.

“In people with OCD, the network of areas that communicate is alwaysworking, working, working. Medication and behavioral therapy can lower theactivity of this brain circuitry. But some people don’t respond, and we use thegamma knife to try to cut the connection,” Lopes tells WebMD.

Not really a knife at all, the gamma knife is a machine that emits powerful,highly focused gamma radiation beams. This helps the doctors target a specificarea of the brain while sparing healthy surrounding tissue. It’s used to treatpeople with braintumors, Parkinson’s disease, and other neurological disorders.

Gamma Knife Relieves OCD Symptoms

At the annual meeting of the American Psychiatric Association, Lopespresented early results of a study that pits the gamma knife against a shamprocedure in 48 patients.

Two years after undergoing the procedure, two of four patients continue tohave significant relief from symptoms, he says. Their memory has improved. Andthey are better able to pay attention to tasks at hand.

In contrast, there has been no improvement among patients who got the shamprocedure.

The procedure was relatively safe, with transient headaches and dizziness among the most common side effects.

However, one patient suffered a manic episode about three months after theprocedure, which was followed by a bout of hallucinations and delusions a fewmonths after that.

“There are some complications, so this is not for everyone,” Lopessays. “This is for people who fail to respond to other treatments.”

But for such patients, the procedure can mean the difference between beinghomebound and functioning “moderately well,” says David Baron, DO,professor and chairman of psychiatry at Temple University in Philadelphia.

“These are patients who have failed every single drug and areessentially nonfunctioning, so even a little improvement is a big deal,” hesays.

Baron tells WebMD that in the U.S., “surgery [for OCD] is an old ideathat is coming back because of the gamma knife. It allows you to be much moreselective and precise with less adverse effects.”

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