Neuroanatomically based approaches to obsessive-compulsive disorder - Neurosurgery and transcranial magnetic stimulation

Obsessive-compulsive disorder is a severe condition. Unfortunately, current medication and behavior therapies fail to adequately benefit some patients most severely affected. Advancing knowledge of brain circuit involvement h as potential treatment implications. The neurosurgical techniques most ofte n used in the United States for crippling, treatment-refractory obsessive-c ompulsive disorder are reviewed in the context of anatomic models of the il lness. The use of transcranial magnetic stimulation to probe possible neuro anatomic and neurophysiologic substrates of this disorder is considered, an d how the knowledge gained from such studies might advance treatment is pre sented.