Dr. Casey Halpern

And I think it's important to educate patients on the risk and benefits of them.

This is deep brain stimulation surgery, but also capsulotomy, which is more of an ablation approach, a little bit like deep brain stimulation, but rather than delivering stimulation through an electrode, you can actually heat the tissue and even destroy it.

Some would say this part of the brain is very safe to destroy.

It's kind of like an appendix.

Others would say it's safer to modulate.

I have seen patients do very well with these ablations.

And so,

You know, you asked me earlier what I find so amazing about the brain, these effects that we can have.

Sometimes the lack of effect is what's so amazing.

You can actually traverse parts of the brain without having any adverse effects on patients' function, at least that you can test, but you can also destroy small parts of the brain.

We're talking three or four millimeters in size.

These little ablations can be really helpful for patients, but have no obvious side effects that we can tell, perhaps after a short recovery from surgery.

But nonetheless, despite how safe they might be, these surgical procedures still are surgical procedures and patients are hesitant to proceed, especially when they know that their chance of a transformative effect is quite low.

We can generally achieve a responder rate of about 50%.

and responders still have symptomatic OCD.

So I'm really sort of inspired to really find a way to deliver these therapies in a more disease-specific or symptom-specific way.

Yeah, this is a disorder of both cortex and the subcortex.

We find that areas in the cortex, like the prefrontal and orbital frontal cortex, are not functioning the way they would in a non-OCD patient.

They are often hyper-operative.

functioning, and we need to find a way to try to normalize their function.