Executive and cognitive functions in patients with extreme obsessive-compulsive disorder treated by capsulotomy.

All patients treated with thermocapsulotomy for obsessive-compulsive disorder (OCD) at Karolinska Hospital between 1978 and 1990 were examined at follow-up with a comprehensive neuropsychological test battery. For comparative reasons the same test battery was applied to current patients with OCD, approved for capsulotomy. Both groups performed within the normal to subnormal range on most tests. In a subgroup of operated patients who did not complete all categories on the Wisconsin Card Sorting Test (WCST), there was a significant positive correlation between time elapsed after capsulotomy and number of categories completed on the WCST. The results would indicate that neuropsychological performance, in general, remains intact after capsulotomy. In some patients executive function is affected, but restoration may take place over time.