Obsessive–compulsive disorder (OCD) is characterized by the presence of often time consuming unwanted and disturbing obsessions (thoughts, urges, or images) and/or repetitive behaviors/mental acts (compulsions), aimed at reducing or preventing anxiety or distress. A range of interventions is effective in the management of OCD, including cognitive behavioral therapy (CBT) and pharmacological therapy. Deep brain stimulation (DBS) for refractory OCD is not yet formally accepted by The World Society for Stereotactic and Functional Neurosurgery (WSSFN) consensus guidelines as an established therapy. However, this statement might be revised after the recent publication of the fourth randomized controlled trial targeting the bed nucleus of the stria terminalis (BNST) (1). Further, recent advances identified a common biological substrate responsible for improvement of obsessions and compulsion following subthalamic nucleus, ventral striatum/ventral capsule (VC/VS), and anterior limb of the internal capsule stimulation (2).

Neuropsychological assessment prior and after surgery aims to monitor cognitive safety but may also identify beneficial cognitive effects and, as such, it could aid to explain for treatment variability. However, while the use of DBS for treatment-refractory OCD seems growing, data on the neuropsychological effects of VC/VS stimulation remain scarce. In this letter, we present the results of neuropsychological evaluation in a case series of treatment-refractory OCD patients receiving VC/VS stimulation.

强迫症（OCD）的特点是经常出现耗时的、不必要的和令人不安的强迫观念（想法、冲动或图像）和/或重复的行为/精神行为（强迫），旨在减少或预防焦虑或痛苦。一系列干预措施可有效治疗强迫症，包括认知行为疗法（CBT）和药物治疗。世界立体定向与功能神经外科学会 (WSSFN) 共识指南尚未正式接受深部脑刺激 (DBS) 治疗难治性强迫症的既定疗法。然而，在最近发表第四项针对终纹床核 (BNST) 的随机对照试验后，这一说法可能会被修改 ( 1 )。此外，最近的进展确定了一种共同的生物基质，负责改善丘脑底核、腹侧纹状体/腹侧囊（VC/VS）和内囊前肢刺激后的强迫观念和强迫行为（2 ）。

手术前后的神经心理学评估旨在监测认知安全性，但也可以识别有益的认知效果，因此，它可以帮助解释治疗的变异性。然而，虽然 DBS 治疗难治性强迫症的应用似乎越来越多，但有关 VC/VS 刺激的神经心理学影响的数据仍然很少。在这封信中，我们介绍了接受 VC/VS 刺激的难治性强迫症患者的一系列病例的神经心理学评估结果。