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Dissociating executive prefrontal substrates following capsulotomy in obsessive-compulsive disorder - PubMed

5 hours ago
  • #Executive function
  • #Capsulotomy
  • #Obsessive-compulsive disorder
  • OCD involves executive function impairments related to fronto-striatal circuits.
  • Capsulotomy, an ablative therapy, was studied in treatment-refractory OCD patients, with post-operative assessments after at least 6 months.
  • The study included OCD capsulotomy patients, OCD controls, and healthy controls, using tasks for set-shifting, working memory, and conflict processing with fMRI and behavioral measures.
  • Capsulotomy improved error-monitoring and behavioral flexibility in the set-shifting tasks, linked to changes in prefrontal areas, but did not affect working memory or conflict processing.
  • Working memory impairments and frontoparietal network dysfunction were observed in both OCD groups, unaffected by capsulotomy.
  • Conflict processing deficits in OCD were also unchanged by capsulotomy, indicating these may be trait markers of OCD.
  • Findings suggest capsulotomy selectively modifies state-dependent cognitive flexibility while leaving other executive deficits intact, informing clinical safety and patient selection for neuromodulation.