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A Review of the Treatment for Refractory Obsessive-Compulsive Disorder: From Medicine to Deep Brain Stimulation

  • David S. Husted and Nathan A. Shapira
Abstract

This article provides an overview of the etiology, epidemiology, and first-line treatment options for obsessive-compulsive disorder (OCD). The subject of treatment-resistant and treatment-refractory OCD is the discussed, including a definition of these often-debated terms, and the latest treatment options delineated. This includes a review of the latest research concerning the pharmacological agents that have been studied as monotherapy or augmenting agents for the treatment of OCD, the use of experimental medications and procedures, treatment with reversible, minimally invasive procedure, such as vagal nerve stimulation and transcranial magnetic stimulation, invasive but the potentially reversible deep brain stimulation, and irreversible lesioning with ablative psychosurgery. A discussion of the role of psychotherapy in the treatment of OCD is also included.

Copyright
Corresponding author
Please direct all correspondence to: David S. Husted, MD, Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100256, Gainesville, FL 32610-0256. E-mail: dhusted@psychiatry.ufl.edu.
References
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1. Stein, DJ, Stone, MH. Essential Papers on Obsessive-Compulsive Disorders. New York, NY: New York University Press; 1997.
2. Karno, M, Goldin, JM, Sorenson, SB et al. , The epidemiology of obsessive compulsive disorder in five US communities. Arch Gen Psychiatry. 1988;45:10941099.
3. Bebbington, PE. Epidemiology of obsessive-compulsive disorder. Br J Psychiatry. 1998;35(suppl):26.
4. Eichstedt, JA, Arnold, SL. Childhood-onset obsessive-compulsive disorder: a tic-related subtype of OCD? Clin Psychol Rev. 2001;21:137157.
5. Geller, PA, Klier, CM, Neugebauer, R. Anxiety disorders following miscarriage. J Clin Psychiatry. 2001;62:432438.
6. Williams, KE, Koran, LM. Obsessive-compulsive disorder in pregnancy, the puerperium, and the premenstruum. J Clin Psychiatry. 1997;58:330334.
7. Swedo, SE, Leonard, HL, Garvey, M et al. , Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998;155:264271.
8. Skoog, G, Skoog, I. A 40-year follow-up of patients with obsessive-compulsive disorder. Arch Gen Psychiatry. 1999;56:121127.
9. Hollander, E, Greenwald, S, Neville, D, Johnson, J, Homig, CD, Weissman, MM. Uncomplicated and comorbid obsessive-compulsive disorder in an epidemiologic sample. Depress Anxiety. 1997;4:111119.
10. Hollander, E. Obsessive-Compulsive Relaxed Disorders. Washington, DC: American Psychiatric Press; 1993.
11. Dupont, RL, Rice, DP, Shiraki, S et al. , Economic costs of obsessive-compulsive disorder. Med Interface. 1995;8:102109.
12. Newth, S, Rachman, S. The concealment of obsessions. Behav Res Ther. 2001;39:457464.
13. Goodman, WK, Price, LH, Rasmussen, SA et al. , The Yale-Brown obsessive compulsive scale. I: development, use, and reliability. Arch Gen Psychiatry. 1989;46:10061011.
14. Goodman, WK, Price, LH, Rasmussen, SA et al. , The Yale-Brown obsessive compulsive scale. II: validity. Arch Gen Psychiatry. 1989;46:10121016.
15. Scahill, L, Riddle, MA, McSwiggin-Hardin, M et al. , Children's Yale-Brown bsessive compulsive scale: reliability and validity. J Am Acad Child Adolesc Psychiatry. 1997;36:844852.
16. Stein, DJ, Hollander, E, and Cohen, L. Neuropsychiatry of obsessive-compulsive disorder. In: Hollander, E, Zohar, J, Marazziti, D, Olivier, B, eds. Current Insists in Obsessive-Compulsive Disorder. Chicester, UK: Wiley; 1994:167182.
17. Rauch, SL, Baxter, LR Jr. Neuroimaging in obsessive-compulsive disorder and related disorders. In: Jenicke, MA, Baer, L, Minichiello, WE, eds. Obsessive-Compulsive Disorders: Practical Management. 3rd ed. St Louis, Mo: Mosby; 1998:289317.
18. Rosenberg, DR, Keshavan, MS. Toward a neurodevelopmental model of obsessive-compulsive disorder. Biol Psychiatry. 1998;43:623640.
19. Hugo, F, van Heerden, BB, Zungu-Dirwayi, N, Stein, DJ. Functional brain imaging in obsessive-compulsive disorder secondary to neurological lesions. Depress Anxiety. 1999;10:129136.
20. Zungu-Dirwayi, N, Hugo, F, van Heerden, BB, Stein, DJ. Are musical obsessions a temporal lobe phenomenon? J Neuropsychiatry Clin Neurosci. 1999;11:398400.
21. Szeszko, PR, Robinson, D, Alvir, JMJ et al. , Orbital frontal and amygdala volume reductions in obsessive-compulsive disorder. Arch Gen Psychiatry. 1999;56:913–19.
22. Baxter, LR, Schwartz, JM, Bergman, KS et al. , Caudate glucose metabolic rate changes with both drug and behavior therapy for OCD. Arch Gen Psychiatry. 1992;49:681689.
23. Tot, S, Ozge, A, Comelekoglu, U et al. , Association of QEEG findings with clinical characteristics of OCD: evidence of left frontotemporal dysfunction. Can J Psychiatry. 2002;47:538545.
24. Bergqvist, PB, Dong, J, Blier, P. Effect of atypical antipsychotic drugs on 5-HT2 receptors in the rat orbito-frontal cortex: an in vivo electrophysiological study. Psychopharmacology. 1999;143:8996.
25. Koran, LM, Pallanti, S, Quercioli, L. Sumatriptan, 5-HT(1D) receptors and obsessive-compulsive disorder. Eur Neuropsychopharmacol. 2001;11:169172.
26. Stem, L, Zohar, J, Cohen, R, Sasson, Y. Treatment of severe, drug resistant obsessive compulsive disorder with the 5-HT(1D) agonist sumatriptan. Eur Neuropsychopharmacol. 1998;8:325328.
27. Mundo, E, Richter, MA, Sam, F, Macciardi, F, Kennedy, JL. Is the 5-HT(1Dbeta) receptor gene implicated in the pathogenesis of obsessive-compulsive disorder? Am J Psychiatry. 2000:157:11601161.
28. Stein, DJ, van Heerden, BB, Wessels, CJ et al. , Single photon emission computed tomography of the brain with tc-99m HMPA O during sumatriptan challenge in obsessive-compulsive disorder: investigating die functional role of the serotonin auto-receptor. Prog Neuropsychopharm Biol Psychiatry. 1999;23:10791099.
29. El Mansari, M, Bouchard, C, Blier, P. Alteration of serotonin release in the guinea pig orbito-frontal cortex by selective serotonin reuptake inhibitors. Neuropsychopharmacology. 1995;13:117127.
30. Goodman, WK, McDougle, CJ, Lawrence, LP. Beyond the serotonin hypothesis: a role for dopamine in some forms of obsessive-compulsive disorder. J Clin Psychiatry. 1990;51(suppl):3643.
31. Swedo, SE, Rapaport, JL, Cheslow, DL et al. , High prevalence of obsessive-compulsive symptoms in patients with Sydenham's chorea. Am J Psychiatry. 1989;146:246249.
32. Leonard, HL, Swedo, SE. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). Int J Neuropsychopharmacol. 2001;4:191198.
33. Eisen, JL, Leonard, HL, Swedo, SE et al. , The use of antibody D8/17 to identify B cells in adults with obsessive-compulsive disorder. Psychiatry Res. 2001;104:221225.
34. Stein, DJ, Goodman, WK, Rauch, SL. The cognitive-affective neuroscience of obsessive-compulsive disorder. Curr Psychiatry Rep. 2000;2:341346.
35. Perlmutter, SJ, Leitman, SF, Garvey, MA et al. , Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorder in childhood. Lancet. 1999;354:11531158.
36. Goodman, WK, Ward, HE, Kablinger, AS, Murphy, TK. Biological approaches to treatment-resistant obsessive-compulsive disorder. In: Goodman, WK, Rudorfer, MV, and Maser, JD, eds. Obsessive-Compulsive Disorder: Contemporary Issues in Management. London, UK: Lawrence Erlbaum Associates; 2000:333369.
37. Grados, MA, Riddle, MA. Pharmacological treatment of childhood obsessive-compulsive disorder: from theory to practice. J Clin Child Psychol. 2001;30:6779.
38. Dougherty, DD, Rauch, SL, Jenike, MA. Pharmacological treatments for obsessive compulsive disorder. In: Nathan, PE, Gorman, JM, eds. A Guide to Treatments That Work. 2nd ed. London, UK: Oxford University Press; 2002:387410.
39. Greist, J, Chouinard, G, DuBoff, E et al. , Double-blind parallel comparison of three dosages of sertraline and placebo in outpatients with obsessive-compulsive disorder. Arch Gen Psychiatry. 1995;52:289295.
40. Tollefson, G, Birkett, M, Koran, L, Genduso, L. Continuation treatment of OCD: double-blind and open-label experience with fiuoxetine. J Clin Psychiatry. 1994;55:6978.
41. Wheadon, DE, Bushnell, WD, Steiner, M. A fixed-dose comparison of 20, 40, or 60 mg paroxetine to placebo in the treatment of OCD. Paper presented at: Annual Meeting of the American College of Neuropsychopharmacology; December 7-11, 1993; Honolulu, Hawaii.
42. Goodman, WK, Price, LH, Rasmussen, SA et al. , Efficacy of fluvoxamine in obsessive-compulsive disorder. A double-blind comparison of fluvoxamine and placebo. Arch Gen Psychiatry. 1989;46:3640.
43. Geller, DA, Biederman, J, Stewart, SE et al. , Which SSR? A meta-analysis of pharmacotherapy in pediatric obsessive-compulsive disorder. Am J Psychiatry. 2003;160:19191928.
44. March, JS, Frances, A, Carpenter, D, Kahn, D. Treatment of obsessive-compulsive disorder: The Expert Consensus Panel for obsessive-compulsive disorder. J Clin Psychiatry. 1997;58(suppl):172.
45. American Academy of Child and Adolescent Psychiatry. Practice parameters for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry. 1998;37(suppl):2745.
46. Ballenger, JC. Treatment of anxiety disorders to temission. J Clin Psychiatry. 2001;62(suppl):59.
47. McDougle, CJ, Goodman, WK, Leckman, JF et al. , Haloperidol addition in fluvoxamine-refractory obsessive-compulsive disorder: a double-blind, placebo-controlled study in patients with and without tics. Arch Gen Psychiatry. 1994;51:302308.
48. Albert, U, Bergesio, C, Pessina, E et al. , Management of treatment resistant obsessive-compulsive disorder: algorithms for pharmacotherapy. Panminerva Med. 2002;44:8391.
49. Marek, GJ, Carpenter, LL, McDougle, CJ, Price, LH. Synergistic action of 5-HT2A antagonists and selective serotonin reuptake inhibitors in neuropsychiatric disorders. Neuropsychopharmacology. 2003;28:402–41.
50. McDougle, CJ, Epperson, CN, Pelton, GH et al. , A double-blind, placebo-controlled study of risperidone addition in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder. Arch Gen Psychiatry. 2000;57:794802.
51. Hollander, E, Ross, NB, Sood, E, Pallanti, S. Risperidone augmentation in treatment-resistant obsessive-compulsive disorder: a double-blind, placebo controlled study. Int J Neuropsychopharmacol. 2003;6:397401.
52. Arias, F, Soto, JA, Garcia, MJ et al. , Efficacy and tolerance of risperidone addition in serotonin reuptake inhibitors (SRI) treatment for refractory obsessive-compulsive disorder. Eur Neuropsychopharmacol. 2002;12(suppl 3):S341.
53. D'Amico, G, Cedro, C, Muscatello, MR et al. , Olanzapine augmentation of paroxetine-refractory obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2003;27:619623.
54. Crocq, MA, Leclercq, P, Guillon, MS, Bailey, PE. Open-label olanzapine in obsessive-compulsive disorder refractory to antidepressant treatment. Eur Psychiatry. 2002;17:296297.
55. Bystritsky, A, Ackerman, DL, Rosen, RM et al. , Augmentation of SSRI response in refractory OCD using adjunct olanzapine: a placebo-controlled trial. APA Annual Meeting, New Research Abstracts; 2001; New Orleans, LA:171172.
56. Shapira, NA, Ward, HE, Mandoki, M et al. , Placebo-controlled trial of fluoxetine versus fiuoxetine plus olanzapine in obsessive-compulsive disorder. Paper presented at: Annual Meeting of the New Clinical Drug Evaluation Unit; May 29, 2003; Boca Raton, FL.
57. Denys, D, Van Megen, H, Westenberg, HGM. Quetiapine addition to serotonin reuptake inhibitor treatment in patients with treatment-refractory obsessive-compulsive disorder: an open-label study. J Clin Psychiatry. 2002;63:700702.
58. Atmaca, M, Kuloglu, M, Tezcan, E, Gecici, O. Quetiapine augmentation in patients with treatment resistant obsessive-compulsive disorder: a single-blind, placebocontrolled study. Int Clin Psychophormacol. 2002;17:115119.
59. McDougle, CJ, Barr, LC, Goodman, WK et al. , Lack of efficacy of clozapine monotherapy in refractory obsessive-compulsive disorder. Am J Psychiatry. 1995;152:18121814.
60. Lykouras, L, Alevizos, B, Michalopoulou, P, Rabavilas, A. Obsessive-compulsive symptoms induced by atypical antipsychotics: a review of the reported cases. Prog Neuropsychopharmacol Biol Psychiatry. 2003;27:333346.
61. de Haan, L, Beuk, N, Hoogenboom, B et al. , Obsessive-compulsive symptoms during treatment with olanzapine and risperidone: a prospective study of 113 patients with recent-onset schizophrenia or related disorders. J Clin Psychiatry. 2002;63:104107.
62. Jenike, MA, Baer, L, Minichiello, WE et al. , Placebo-controlled trial of fiuoxetine and phenelzine for obsessive-compulsive disorder. Am J Psychiatry. 1997;154:12611264.
63. Pigott, TA, Pato, MT, L'Heureux, F et al. , A controlled comparison of adjuvant lithium carbonate or thyroid hormone in clomipramine-treated patients with obsessive-compulsive disorder. J Clin Psychopharmacol. 1991;11:242248.
64. McDougle, CJ, Price, LH, Goodman, WK et al. , A controlled trial of lithium augmentation in fluvoxamine-refractory obsessive compulsive disorder: lack of efficacy. J Clin Psychopharmacol. 1991;11:175184.
65. Pigott, TA, L'Heureux, F, Hill, JL et al. , A double-blind study of adjuvant buspirone hydrochloride in clomipramine-treated patients with obsessive-compulsive disorder. J Clin Psychopharmocol. 1992;12:1118.
66. McDougle, CJ, Goodman, WK, Leckman, JF et al. , Limited therapeutic effect of addition of buspirone in fluvoxamine-refractory obsessive-compulsive disorder. Am J Psychiatry. 1993;150:647649.
67. Grady, TA, Pigott, TA, L'Heureux, F et al. , Double-blind study of adjuvant buspirone for fluoxetine-treated patients with obsessive-compulsive disorder. Am J Psychiatry. 1993;150:819821.
68. Pigott, TA, L'Heureux, F, Rubenstein, CS et al. , A double-blind, placebo-controlled study of trazodone in patients with obsessive-compulsive disorder. J Clin Psychopharmacol. 1992;12:156162.
69. Dannon, PN, Sasson, Y, Hirschmann, S et al. , Pindolol augmentation in treatment-resistant obsessive compulsive: double-blind placebo controlled trial. Eur Neuropsychopharmacol. 2000;10:165169.
70. Koran, LM, Mueller, K, Maloney, A. Will pindolol augment the response to a serotonin reuptake inhibitor in obsessive-compulsive disorder? J Clin Psychopharmacol. 1996;16:253254.
71. Blier, P, Bergeron, R. Sequential administration of augmentation strategies in treatment-resistant obsessive-compulsive disorder: preliminary findings. Int Clin Psychopharmacol. 1996;11:3744.
72. Jenike, MA. Drug treatment of obsessive-compulsive disorder. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive Compulsive Disorders: Theory and Management. 2nd ed. Chicago, IL: Year Book Medical; 1990:249282.
73. Pigott, TA, L'Heureux, FL, Rubenstein, CS. A controlled trial of clonazepam augmentation in OCD patients treated with clomipramine or fiuoxetine. New Research Abstract. 144, 145th Annual Meeting of the American Psychiatric Association, Washington, DC, 1992;82.
74. Hollander, E, DeCaria, CM, Schneier, FR et al. , Fenfluramine augmentation of serotonin reuptake blockade antiobsessional treatment. J Clin Psychiatry. 1990;51:119123.
75. Hollander, E, Friedberg, J, Wasserman, S et al. , Venlafaxine in treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry. 2003;64:546550.
76. Albert, U, Aguglia, E, Maina, G, Bogetto, F. Venlafaxine versus clomipramine in the treatment of obsessive-compulsive disorder: a preliminary single-blind, 12-week, controlled study. J Clin Psychiatry. 2002;63:10041009.
77. Denys, D, Van Der Wee, N, Van Megen, HJ, Westenberg, HG. A double-blind comparison of venlafaxine and paroxetine in obsessive-compulsive disorder. J Clin Psychopharmacol. 2003;23:568575.
78. Deltito, JA. Valproate pretreatment for the difficult-to-treat patient with OCD [letter]. J Clin Psychiatry. 1994;55:500.
79. Joffe, RT, Swinson, RP. Carbamazepine in obsessive-compulsive disorder. Biol Psychiatry. 1987;45:122124.
80. Cora-Locatelli, G, Greenberg, BD, Martin, J, Murphy, DL. Gabapentin augmentation for fluoxetine-treated patients with obsessive-compulsive disorder [letter]. J Clin Psychiatry. 1998;59:480481.
81. Sporn, J, Smith, M, Jersino, JM et al. , A double-blind, placebo-controlled trial of gabapentin augmentation of fluoxetine for treatment of obsessive-compulsive disorder (OCD) Poster presented at: New Clinical Drug Evaluation Unit Program May 28-31, 2001; Phoenix, Ariz.
82. Iwata, Y, Kotani, Y, Hoshino, R et al. , Carbamazepine augmentation of clomipramine in the treatment of refractory obsessive-compulsive disorder [letter]. J Clin Psychiatry. 2000;61:528529.
83. McMeekin, H. Successful treatment of obsessive-compulsive disorder with oxcarbazepine: a case report. JSC Med Assoc. 2003;98:316320.
84. Ramesh, TC, Khanna, S. Lamotrigine augmentation of serotonin re-uptake inhibitors in obsessive-compulsive disorder [letter]. Aust N Z J Psychiatry. 2000;34:527528.
85. Fallon, BA, Liebowitz, MR, Campeas, R et al. , Intravenous clomipramine for obsessive-compulsive disorder refractory to oral clomipramine: a placebo-controlled study. Arch Gen Psychiatry. 1998;55:918924.
86. Pallanti, S, Quercioli, L, Koran, LM. Citalopram intravenous infusion in resistant obsessive-compulsive disorder: an open trial. J Clin Psychiatry 2002;63:796801.
87. Koran, LM, Sallee, FR, Pallanti, S. Rapid benefit of intravenous pulse loading of clomipramine in obsessive-compulsive disorder. Am J Psychiatry. 1997; 154:396401.
88. Fux, M, Levine, J, Aviv, A, Belmaker, RH. Inositol treatment of obsessive-compulsive disorder. Am J Psychiatry. 1996;153:12191221.
89. Fux, M, Benjamin, J, Belmaker, RH. Inositol versus placebo augmentation of serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder: a double-blind cross-over study. Int J Neuropsychopharmacol. 1999;2:193195.
90. Harvey, BH, Brink, CB, Seedat, S, Stein, DJ. Defining the neuromolecular action of myo-inositol: application to obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26:2132.
91. Shapira, NA, Keck, PE, Goldsmith, TD et al. , Open-label pilot study of tramadol hydrochloride in treatment-refractory obsessive-compulsive disorder. Depress Anxiety. 1997;6:170173.
92. Koran, LM, Bullock, KD, Franz, BE et al. , Double-blind oral morphine in treatment-resistant OCD. Presented at: Annual Meeting of the American Psychiatric Association. May 17-22, 2003; San Francisco, Calif.
93. Tao, R, Auerbach, SR. Increased extracellular serotonin in rat brain after systemic or intraraphe administration of morphine. J Neurochem. 1994;63:517524.
94. Spampinato, U. Serotonin agonists reduce dopamine synthesis in the striatum only when the impulse flow of nigro-striatal neurons is intact. Brain Res. 1985;328:8995.
95. Koran, LM, Quirk, T, Lorberbaum, JP, Elliott, M. Mirtazapine treatment of obsessive-compulsive disorder [letter]. J Clin Psychopharmacol. 2001;21:537539.
96. Koran, LM, Chuong, HW. Mirtazapine treatment for adult OCD. Poster presented at: Annual Meeting of the American Psychiatric Association. May 17-22, 2003; San Francisco, Calif.
97. Maina, G, Albert, U, and Bogetto, F. Relapses after discontinuation of drug associated with increased resistance to treatment in obsessive-compulsive disorder. Int J Neuropsychopharmacol. 2001;16:3338.
98. Freud, S. Two case histores: little Hans and the rat man. In: Strachey, J, ed. The Standard Edition of the Complete Psychological Works of Sigmund Freud. Vol 10. London, UK: Hogarth Press; 1953.
99. Keijsers, G, Hoogduin, C, Shaap, C. Predictors of treatment outcome in the behavioural treatment of obsessive-compulsive disorder. Br J Psychiatry. 1994;165:781786.
100. Marks, I. Behavior therapy for obsessive-compulsive disorder: a decade of progress. Can J Psychiatry. 1997;42:1021–27.
101. Foa, EB, Kozak, MJ. Psychological treatment for obsessive-compulsive disorder. In: Mavissakalian, MR, Prien, RF, eds. Long-term Treatments of Anxiety Disorders. Washington, DC: American Psychiatric Press; 1996:285309.
102. Christensen, H, Hadzi-Pavlovic, D, Andrews, G, Mattick, R. Behavior therapy and tricyclic medication in the treatment of obsessive-compulsive disorder: a quantitative review. J Consult Clin Psychol. 1987:55:701711.
103. Cox, BJ, Swinson, RP, Morrison, B, Lee, PS. Clomipramine, fluoxetine, and behavior therapy in the treatment of obsessive-compulsive disorder: a meta-analysis. J Behav Ther Exp Psychiatry. 1993;24:149153.
104. van Balkom, AJ, van Oppen, P, Vermeulen, AW et al. , A meta-analysis on the treatment of obsessive-compulsive disorder: comparison of antidepressants, behavior, and cognitive therapy. Clin Psychol Rev. 1994;5:359381.
105.Hembree, EA, Riggs, DS, Kozak, MJ et al. , Long-term efficacy of exposure and ritual prevention therapy and serotonergic medications for obsessive-compulsive disorder. CNS Spectr. 2003;8:363–371,381.
106. Albert, U, Maina, G, Forner, F, Bogetto, F. Cognitive-behavioral therapy in obsessive-compulsive disorder patients partially unresponsive to SRIs [abstract]. Eur Neuropsychopharmacol 2003;13(suppl 4):S357–S358.
107. James, IA, Blackburn, IM. Cognitive therapy with obsessive-compulsive disorder. Br J Psychiatry. 1995; 166:444450.
108. Fals-Stewart, W, Marks, AP, Schafer, J. A comparison of behavioral group therapy and individual behavior therapy in treating obsessive-compulsive disorder. J Nerv Ment Dis. 1993;181:189193.
109. van Noppen, BL, Pato, MT, Marsland, R, Rasmussen, SA. A time-limited behavioral group for treatment of obsessive-compulsive disorder. J Psychother Pract Res. 1998;7:272280.
110. Rauch, SL, Jenike, MA, Alpert, NM et al. , Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using 15-0 labeled CO2 and positron emission tomography. Arch Gen Psychiatry. 1994;1:6270.
111. Saxena, S, Brody, AL, Schwartz, JM, Baxter, LR. Neuorimaging and frontal-subcortical circuitry in obsessive compulsive disorder. Br J Psychiatry. 1998;173(suppl 35):2638.
112. Vogt, BA, Pandya, DN. Cingulate cortex of the rhesus monkey. II: Cortical afferents. J Comp Neurol. 1987;262:271289.
113. Cavada, C, Company, T, Tejedor, J et al. , The anatomical connections of the macaque monkey orbitofrontal cortex. Cereb Cortex. 2000;10:220242.
114. Kemp, JM, Powell, TPS. The cortico-striate projections in the monkey. Brain. 1970;93:525546.
115. Martuza, RL, Chiocca, EA, Jenike, MA et al. , Stereotactic radiofrequency thermal cingulotomy for obsessive compulsive disorder. J Neuropsychiatry Clin Neurosci. 1990;2:331336.
116. Cosgrove, GR, Rauch, SL. Psychosurgery. Neurosurg Clin N Am. 1995;6:167176.
117. Kelly, D, Richardson, A, Mitchell-Heggs, N. Stereotactic limbic leucotomy: neuro-physiological aspects and operative technique. Br J Psychiatry. 1973;123:133140.
118. Rauch, SL, Markris, N, Cosgrove, GR et al. , A magnetic resonance imaging study of regional cortical volumes following sterotactic anterior cingulotomy. CNS Spectr. 2001;6:214222.
119. Sachdev, P, Trollor, J, Walker, A et al. , Bilateral orbitomedial leuocotomy for obsessive-compulsive: a single-case study using positron emission tomography. Aust N ZJ Psychiatry. 2001;35:684690.
120. Cosgrove, GR, Ballantine, HT Jr. Cingulotomy in psychosurgery. In: Goldenberg, PL, Tasker, RR, eds. Textbook of Sterotoctic and Functional Neurosurgery. New York, NYMcGraw-Hill; 1998:19651970.
121. Dougherty, DD, Baer, L, Cosgrove, GR et al. , Update on cingulotomy for intractable obsessive-compulsive disorder: prospective long-term follow-up of 44 patients. Am J Psychiatry. 2002;159:269275.
122. Baer, L, Rauch, SL, Ballantine, HT Jr et al. , Cingulotomy for intractable obsessive-compulsive disorder. Prospective long-term follow-up of 18 patients. Arch Gen Psychiatry. 1995;52:384392.
123. Marin, RS. Apathy: Concept, syndrome, neural mechanisms, and treatment. Semin Clin Neuropsychiatry. 1996;1:304314.
124. Athwal, BS, Berkley, KJ, Hussain, I et al. , Brain responses to changes in bladder volume and urge to void in healthy men. Brain. 2001;124:369377.
125. Devinsky, O, Morrell, MJ, Vogt, BA. Contributions of the anterior cingulated cortex to behavior. Brain. 1995;118:279306.
126. Ballantine, HT Jr. Neurosurgery for behavioral disorders. In: Wilkins, RH, Rengachary, SS, eds. Neurosurgery. New York, NY: Etsevier/North Holland Biomedical Press;1985:25272537.
127. Kim, CH, Chang, JW, Koo, MS et al. , Anterior cingulotomy for refractory obsessive-compulsive disorder. Acta Psychiarr Scand. 2003;107:283290.
128. Spangler, WJ, Cosgrove, GR, Ballantine, HT et al. , Magnetic resonance image-guided stereotactic cingulotomy for intractable psychiatric disease. Neurosurgery. 1996;38:10711078.
129. Jenike, MA, Baer, L, Ballantine, HT Jr et al. , Cingulotomy for refractory obsessive-compulsive disorder: A long-term follow-up of 33 patients. Arch Gen Psychiatry. 1991;48:548555.
130. Rauch, SL, Dougherty, DD, Cosgrove, GR et al. , Cerebral metabolic correlates as potential predictors of response to anterior cingulotomy for obsessive compulsive disorder. Biol Psychiatry. 2001;50:659667.
131. Montoya, A, Weiss, AP, Price, BH et al. , Magnetic resonance imaging-guided stereotactic limbic leucotomy for treatment of intractable psychiatric disease. Neurosurgery. 2002;50:10431052.
132. Hay, P, Sachdev, P, Cumming, S et al. , Treatment of obsessive-compulsive disorder by psychosurgery. Acta Psychiatr Scand. 1993;87:197207.
133. Kim, MC, Lee, TK, Choi, CR. Review of long-term results of stereotactic psychosurgery. Neurol Med Chir (Tokyo). 2002;42:365371.
134. George, MS, Post, RM, Ketter, TA et al. , Neural mechanisms of mood disorders. Curr Rev Mood Anxiety Disord. 1997;1:7183.
135. Van Bockstaele, EJ, Peoples, J, Valentino, RJ. Anatomic basis for differential regulation of the rostrolateral peri-locus coeruleus region by limbic afferents. Biol Psychiatry. 1999;46:13521363.
136. Malhi, GS, Sachdev, P. Novel physical treatments for the management of neuro-psychiatric disorders. J Psychosom Res. 2002;53:709719.
137. Harden, CL, Pulver, MC, Ravdin, CL et al. , A pilot study of mood in epilepy patients treated with vagus nerve stimulation. Epilepsy Behav. 2002;1:9399.
138. Jobe, PC, Dailey, JW, Wernicke, JF. A noradrenergic and serotonergic hypothesis of the linkage between epilepsy and affective disorders. Orit Rev Neurobiol. 1999;13:317356.
139. Rush, AJ, George, MS, Sackeim, HA et al. , Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study. Biol Psychiatry. 2000;47:276286.
140. Ward, H, Ninan, PT, Pollack, M et al. , Treatment-refractory obsessive-compulsive disorder: potential benefit of VNS therapy. Poster presented at: Annual Meeting of the Anxiety Disorders Association of America. March 27-30, 2003; Toronto, Canada.
141. George, MS, Lisanby, SH, Sackeim, HA. Transcranial magnetic stimulation: applications in psychiatry. Arch Gen Psychiatry. 1999;56:300311.
142. Greenberg, BD, Rezai, AR. Mechanisms and the current state of deep brain stimulation in neuropsychiatry. CNS Spectr. 2003;8:522526.
143. Nuttin, BJ, Gabriels, LA, Cosyns, PR et al. , Long-term electrical capsular stimulation in patients with obsessive-compulsive disorder. Neurosurgery. 2003;52:12631274.
144. Barker, AT, Jalinous, R, Freeston, IL. Non-invasive stimulation of the human motor cortex. Lancet. 1985;1:11061107.
145. Greenberg, BD, George, MS, Dearing, J et al. , Effect of prefrontal repetitive transcranial magnetic stimulation (rTMS) in obsessive-compulsive disorder: a preliminary study. Am J Psychiatry. 1997;154:867869.
146. Alonso, P, Pujol, J, Cardoner, N et al. , Right prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: A double-blind, placebo-controlled study. Am J Psychiatry. 2001;158:11431145.
147. Martin, JLR, Barbanoj, MJ, Clos, S. Transcranial magnetic stimulation (TMS) for the treatment of obsessive-compulsive disorder (OCD). Cochrane Database Syst Rev 2003;3:CD003387.
148. Wasserman, EM. Risk and safety of repetitive transcranial magnetic stimulation (report and suggested guidelines from the International Workshop in the Safety of Repetitive Trnascranial Magnetic Stimulation, June 5-7, 1996). Electroencephalogr Clin Neurophysiol. 1998;108:116.
149. Wasserman, EM, Cohen, LG, Flitman, SS et al. , Seizures in healthy people with repeated “safe” trains of transcranial magnetic stimuli. Lancet. 1996;347:825826.
150. Rudorfer, MV. Electroconvulsive therapy in treatment-refractory obsessive-compulsive disorder. In: Goodman, WK, Rudorfer, MV, Maser, JD, eds. Obsessive-Compulswe Disorder: Contemporary Issues in Management. London, UK: Lawrence Erlbaum Associates; 2000:431455.
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CNS Spectrums
  • ISSN: 1092-8529
  • EISSN: 2165-6509
  • URL: /core/journals/cns-spectrums
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