title: Long-term follow-up of bilateral anterior capsulotomy in patients with refractory obsessive-compulsive disorder.
abstract: BACKGROUND
  Obsessive-compulsive disease (OCD) is a severe psychiatric disorder suffers tens of millions of people around the world. There are many treatment options available, however, still nearly 40% of OCD patients do not respond very well to the therapeutic methods. For treatment-refractory OCD patients, bilateral anterior capsulotomy is a potential therapy.
  
  
  METHODS
  53 (32 men and 21 women) medically intractable OCD patients who underwent MRI guided bilateral anterior capsulotomy from 2003 to 2006 were included in this study. Pre- and post-operative Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores were recorded by psychiatrists. FDG-PET was performed pre-operatively and 12 months after the operation to assess the effect of the operation.
  
  
  RESULTS
  There was a marked difference in FDG-PET findings before and 12 months after the operation. For OCD symptoms, 20 (37.9%) cases were regarded as OCD symptoms free, 13 (24.5%) cases as significant improved, 8 (15.0%) cases as clinical improved and 12 (22.6%) cases experienced no effects or improvements. There is also a significant difference in Y-BOCS, HAMD and HAMA scores (two-tailed t-test).
  
  
  CONCLUSIONS
  Our study indicates that bilateral capsulotomy is a precise and relatively safe therapy for refractory OCD, which can improve patients' quality of life and restores their social function. There must be strict inclusion criteria for patients considering of the complications and the irreversibility of this procedure.
authors.affiliation: Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Shikun
authors.initials: S
authors.lastname: Zhan
authors.affiliation: Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Dianyou
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Sijian
authors.initials: S
authors.lastname: Pan
authors.affiliation: Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yongchao
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Guozhen
authors.initials: G
authors.lastname: Lin
authors.affiliation: Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: bominsun@163.com.
authors.forename: Bomin
authors.initials: B
authors.lastname: Sun
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020772:Internal Capsule / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009771:Obsessive-Compulsive Disorder / Q000000981:diagnostic imaging / Q000601:surgery*; D049268:Positron-Emission Tomography; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Long-term follow-up; MRI guided capsulotomy; Neural pathways; PET-CT; Refractory obsessive-compulsive disorder