Obsessive-compulsive disorder (OCD) is an anxiety disorder associated with 
recurrent intrusive thoughts and repetitive behaviors. Although conventional 
pharmacological and/or psychological treatments are well established and 
effective in treating OCD, symptoms remain unchanged in up to 30% of patients. 
Deep brain stimulation (DBS) of the anterior limb of the internal capsule has 
recently been proposed as a possible therapeutic alternative in 
treatment-resistant OCD. In the present study, the authors tested the hypothesis 
that DBS of the ventral caudate nucleus might be effective in a patient with 
intractable severe OCD and concomitant major depression. Psychiatric assessment 
included the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Hamilton 
Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), and 
the Global Assessment of Functioning (GAF) Scale for determining the symptom 
severity of OCD, depression, and anxiety as well as the quality of pychosocial 
and occupational functioning, respectively. Neuropsychological assessment 
consisted of a wide range of tests primarily exploring memory and executive 
functions. Deep brain stimulation of the ventral caudate nucleus markedly 
improved symptoms of depression and anxiety until their remission, which was 
achieved at 6 months after the start of stimulation (HDRS < or = 7 and HARS < or 
= 10). Remission of OCD (Y-BOCS < 16) was also delayed after 12 or 15 months of 
DBS. The level of functioning pursuant to the GAF scale progressively increased 
during the 15-month follow-up period. No neuropsychological deterioration was 
observed, indicating that DBS of the ventral caudate nucleus could be a 
promising strategy in the treatment of refractory cases of both OCD and major 
depression.