Obsessive-Compulsive Disorder (OCD) involves hyperactive cortical areas like the prefrontal cortex and their projections to subcortical structures such as the ventral striatum, including the nucleus accumbens. While SSRIs and exposure response prevention are first-line treatments, about 30% of patients remain symptomatic. For these severe cases, surgical options like DBS or capsulotomy (ablation) are considered, aiming to modulate or disrupt dysfunctional circuits, though response rates are around 50%.

Impact: High. Details the neurobiological underpinnings of OCD and the limitations of current treatments, justifying the need for advanced interventions like DBS and ablation.

In the source video, this keypoint occurs from 00:10:22 to 00:17:00.

Sources in support: Casey Halpern (Guest, Professor of Neurosurgery)