B – 23 Laser Interstitial Thermal Therapy (LITT) impact on Executive Functioning in Refractory Obsessive Compulsive Disorder controlling for Practice Effects and Depression

Abstract Objective Laser Interstitial Thermal Therapy (LITT) is a surgical intervention that utilizes magnetic resonance imaging to guide lasers aimed at realigning neural circuitry underlying refractory obsessive-compulsive disorder. Methodological issues, including lack of adjustment for the impact of repeated exposures and common comorbid depression, in prior studies (Zaballa et. al, 2023) warrants caution regarding published findings. The current study aims to examine the surgical impact on executive functioning in a cohort of patients with severe refractory OCD post-M-LITT surgery using reliable change indices and adjusting for depressive symptomatology. Method Retrospective review of the medical records and neuropsychological reports of 17 consecutive patients with intractable OCD before and after capsulotomy was conducted. Baseline mean age was 35.35 years (SD = 19.03) and an average of 14.6 (SD = 2.23) years of education. The majority were Caucasian (94%) and male (64%). OCD and depressive symptomology were assessed using the Y-BOCS and BDI-II. SCWT, DKEFS, COWAT, Tower Test and TMT-B constituted the executive battery. Pre-and-post surgery performances were examined using Reliable Change Index (RCI) calculation co-varying depression total score. Results Post surgery, Y-BOCS mean score decreased from 32 (SD = 5.87) to 20 (SD = 11.15). Depressive symptoms decreased from 28 (SD = 15.40) to 17 (SD = 16.62). Executive functioning proved stable post-capsulotomy even when accounting for depression. Conclusion LITT was found to be a safe intervention even when controlling for practice effects and mood state. Along with improvement in OCD symptomology, LITT resulted in stable executive skills and reduced depression symptomology.