title: Long-term follow-up of mri-guided bilateral anterior capsulotomy in patients with refractory schizophrenia.
abstract: OBJECTIVE
  To determine whether there is a long-term benefit of MRI-guided bilateral anterior capsulotomy in the treatment of refractory schizophrenia.
  
  
  METHODS
  116 patients (16 patients did not complete the follow-up evaluation) with refractory schizophrenia who underwent capsulotomy were included. The treatment effect was evaluated using a series of international rating scales. Evaluations were performed at baseline, 3 weeks and 24 months after surgery.
  
  
  RESULTS
  The rate of effectiveness was 74% according to the Clinical Global Impression evaluation, and there was an obvious improvement based on the statistical analysis for Positive and Negative Symptom Scale (baseline vs. 24 months after surgery, 6.86 ± 8.12, 10.70 ± 8.70 vs. 26.65 ± 4.85, 21.66 ± 7.19), Brief Psychiatric Rating Scale (14.75 ± 13.21 vs. 44.97 ± 9.36), Activities of Daily Living Scale (18.06 ± 6.58 vs. 24.61 ± 8.95), Social Disability Screening Schedule (6.69 ± 6.12 vs. 15.06 ± 3.18) and Global Assessment Scale (74.35 ± 12.75 vs. 48.74 ± 9.18). Among all the symptoms of schizophrenia, aggressive behavior (82% response rate), hallucination, (71% response rate) and delusion (70% response rate) showed the best response.
  
  
  CONCLUSIONS
  Our research indicates that capsulotomy is a relatively safe and effective intervention for patients with refractory schizophrenia. It could be an alternative therapy for those patients with chronic and severe schizophrenia. But there must be strict inclusion criteria considering the complications and irreversibility of this procedure.
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Hao
authors.forename: Shikun
authors.initials: S
authors.lastname: Zhan
authors.forename: Dianyou
authors.initials: D
authors.lastname: Li
authors.forename: Sijian
authors.initials: S
authors.lastname: Pan
authors.forename: Yongchao
authors.initials: Y
authors.lastname: Li
authors.forename: Guozhen
authors.initials: G
authors.lastname: Lin
authors.forename: Guihua
authors.initials: G
authors.lastname: Pan
authors.forename: Radfan
authors.initials: R
authors.lastname: Mahyoub
authors.forename: Bomin
authors.initials: B
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D010054:Brief Psychiatric Rating Scale; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020772:Internal Capsule / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000639:trends; D008297:Male; D008875:Middle Aged; D011612:Psychosurgery / Q000379:methods* / Q000639:trends; D012559:Schizophrenia / Q000175:diagnosis / Q000601:surgery*; D012565:Schizophrenic Psychology; D013238:Stereotaxic Techniques / Q000639:trends; D013997:Time Factors; D055815:Young Adult