title: Stereotactic treatment of refractory obsessive compulsive disorder by bilateral capsulotomy with 3 years follow-up.
abstract: In order to study the clinical effect of bilateral capsulotomy in patients with refractory obsessive compulsive disorder (OCD), 35 patients with refractory obsessive compulsive disorder for whom anti-OCD medications and psychological/behavior therapy had failed, underwent MRI-guided stereotactic bilateral anterior capsulotomy. Pre- and post-operative Yale-Brown obsessive compulsive scale (Y-BOCS), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) scores were determined by psychiatrists. All patients underwent fluorodeoxyglucose positron emission tomography evaluation before and 6 months after the operation. Twenty patients became OCD symptom-free (57%), 10 experienced significant improvement (29%) and five experienced no significant improvement (14%). There were significant decreases in Y-BOCS, HAMD and HAMA scores. Our results show that MRI-guided stereotactic bilateral capsulotomy is a precise, safe and effective therapy for refractory obsessive compulsive disorder. This promising technique may also improve anxiety and depression in addition to OCD. OCD patients who have not responded to medication, psychotherapy or behavioral therapy might benefit from MRI-guided stereotactic bilateral capsulotomy.
authors.affiliation: Department of Neurology, Affiliated Second Hospital, Soochow University, Suzhou, Jiangsu, China. liukangyong555@yahoo.com.cn
authors.forename: Kangyong
authors.initials: K
authors.lastname: Liu
authors.forename: Haiyin
authors.initials: H
authors.lastname: Zhang
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Liu
authors.forename: Yihui
authors.initials: Y
authors.lastname: Guan
authors.forename: Liqin
authors.initials: L
authors.lastname: Lang
authors.forename: Yanbo
authors.initials: Y
authors.lastname: Cheng
authors.forename: Bomin
authors.initials: B
authors.lastname: Sun
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Chuantao
authors.initials: C
authors.lastname: Zuo
authors.forename: Li
authors.initials: L
authors.lastname: Pan
authors.forename: Heding
authors.initials: H
authors.lastname: Xu
authors.forename: Shunjun
authors.initials: S
authors.lastname: Li
authors.forename: Lihua
authors.initials: L
authors.lastname: Shi
authors.forename: Jinjun
authors.initials: J
authors.lastname: Qian
authors.forename: Yaping
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D020772:Internal Capsule / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D049268:Positron-Emission Tomography / Q000379:methods; D011612:Psychosurgery / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013238:Stereotaxic Techniques
chemical_list: D019788:Fluorodeoxyglucose F18