Rambam Medical Center Finds Solution for Treatment-Resistant OCD

The operation involved implanting four electrodes in two separate regions of the brain rather than the standard approach of two electrodes in a single target area.

By Shula Rosen

For the first time in Israel, surgeons at Rambam Medical Center have carried out an advanced form of deep brain stimulation on a patient with severe obsessive–compulsive disorder that failed to respond to medication or psychotherapy, opening a new clinical option for the most extreme cases.

The operation involved implanting four electrodes in two separate regions of the brain, rather than the standard approach of two electrodes in a single target area.

The goal is to modulate multiple interconnected neural circuits involved in anxiety, emotional regulation, and impulse control.

The procedure was performed on a woman in her 40s from northern Israel who had lived for years with progressively disabling OCD that affected her family life, independence, and ability to function.

OCD affects roughly 1.2% of the population. While many patients improve with medication or cognitive behavioral therapy, a subset develops resistance to all standard treatments. For those individuals, options become limited and quality of life can deteriorate sharply.

Deep brain stimulation has been used for more than a decade in neurological disorders such as Parkinson’s disease and is also approved by the US Food and Drug Administration for severe, treatment-resistant OCD.

In Israel, however, DBS for psychiatric conditions is not included in the national health basket and is offered only in exceptional cases or within research frameworks.

During the surgery, electrodes were implanted deep within the brain and connected to a pacemaker placed under the skin, which delivers continuous, adjustable electrical pulses. “The goal is not to ‘turn off’ an area of the brain but to balance its activity,” Dr. Renana Eitan, director of the neuropsychiatric clinic at Kfar Shaul, who is overseeing the patient’s care, told The Jerusalem Post.

“There are several areas relevant to OCD, and in some cases stimulating one area is not enough.”

The dual-target approach allows surgeons to work on more than one neural pathway at the same time. The procedure is a national first that enables more personalized treatment strategies.

International studies suggest response rates of up to 80% in highly treatment-resistant patients. Early assessments in this case have been encouraging, though the patient is still undergoing long-term adjustment and follow-up. Researchers caution that the approach remains experimental but say its implications could extend beyond OCD to other hard-to-treat neurological and psychiatric conditions.