Deep brain stimulation for obsessive-compulsive disorder: Why phenotype matters

The history of neurosurgical treatment for obsessive-compulsive disorder (OCD) has closely followed evolving concepts of how psychiatric symptoms arise from dysfunctional brain circuits. Early psychosurgical procedures rested on the premise that pathological interactions between frontal cortical and subcortical regions could be disrupted by surgical lesions. With the development of stereotactic functional neurosurgery, procedures such as anterior capsulotomy allowed increasingly precise, anatomically defined interventions.