title: Evaluation of bilateral cingulotomy and anterior capsulotomy for the treatment of aggressive behavior.
abstract: BACKGROUND
  Agressiveness is a psychiatric symptom that may be part of schizophrenia, mental retardation, drug abuse and other conditions. Surgical treatment remains controversial and few therapeutic options are available. We undertook this study to perform a prospective analysis on the efficacy and safety of bilateral cingulotomy and anterior capsulotomy in the treatment of aggressiveness behavior.
  
  
  METHODS
  We studied 25 patients with a primary diagnosis of aggressiveness refractory to conventional treatment. Subjects were clinically evaluated with the Mayo-Portland adaptability inventory and the Global Assessment of Functioning score. Lesions were placed stereotactically in both targets and confirmed by postoperative magnetic resonance imaging. Significant changes were evaluated with Wilcoxon test after 3 and 6 months.
  
  
  RESULTS
  According to inclusion and exclusion criteria, only 12 patients were finally included and surgical treated. Lesions significantly decreased using the Mayo-Portland adaptability inventory and the Global Assessment of Functioning score (p <0.002) at 3 and 6 months follow-up. Only five patients showed either mild or transitory postsurgical complications.
  
  
  CONCLUSIONS
  Combined bilateral anterior capsulotomy and cingulotomy successfully reduced aggressiveness behavior and improved clinical evaluations. These effects were obtained with fewer complications than previously described targets.
authors.affiliation: Unidad de Neurocirugía Funcional, Esterotaxia y Radiocirugía, Hospital General de México, Secretaría de Salud, México, D. F., Mexico. fiacroj@yahoo.com
authors.forename: Fiacro
authors.initials: F
authors.lastname: Jiménez-Ponce
authors.forename: Julián Eduardo
authors.initials: JE
authors.lastname: Soto-Abraham
authors.forename: Ylián
authors.initials: Y
authors.lastname: Ramírez-Tapia
authors.forename: Francisco
authors.initials: F
authors.lastname: Velasco-Campos
authors.forename: José Damián
authors.initials: JD
authors.lastname: Carrillo-Ruiz
authors.forename: Paulina
authors.initials: P
authors.lastname: Gómez-Zenteno
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000601:surgery*; D006179:Gyrus Cinguli / Q000601:surgery*; D006801:Humans; D006963:Hyperphagia / Q000209:etiology; D008607:Intellectual Disability / Q000523:psychology; D008032:Limbic System / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020335:Paraparesis / Q000209:etiology; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology; D011581:Psychological Tests; D011612:Psychosurgery; D012565:Schizophrenic Psychology; D012920:Social Behavior Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult