title: Visuospatial Memory Improvement after Gamma Ventral Capsulotomy in Treatment Refractory Obsessive-Compulsive Disorder Patients.
abstract: Gamma ventral capsulotomy (GVC) radiosurgery is intended to minimize side effects while maintaining the efficacy of traditional thermocoagulation techniques for the treatment of refractory obsessive-compulsive disorder (OCD). Neuropsychological outcomes are not clear based on previous studies and, therefore, we investigated the effects of GVC on cognitive and motor performance. A double-blind, randomized controlled trial (RCT) was conducted with 16 refractory OCD patients allocated to active treatment (n=8) and sham (n=8) groups. A comprehensive neuropsychological evaluation including intellectual functioning, attention, verbal and visuospatial learning and memory, visuospatial perception, inhibitory control, cognitive flexibility, and motor functioning was applied at baseline and one year after the procedure. Secondary analysis included all operated patients: eight from the active group, four from the sham group who were submitted to surgery after blind was broken, and five patients from a previous open pilot study (n=5), totaling 17 patients. In the RCT, visuospatial memory (VSM) performance significantly improved in the active group after GVC (p=0.008), and remained stable in the sham group. Considering all patients operated, there was no decline in cognitive or motor functioning after one year of follow-up. Our initial results after 1 year of follow-up suggests that GVC not only is a safe procedure in terms of neuropsychological functioning but in fact may actually improve certain neuropsychological domains, particularly VSM performance, in treatment refractory OCD patients.
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Marcelo C
authors: MC
authors: Batistuzzo
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Marcelo Q
authors: MQ
authors: Hoexter
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Anita
authors: A
authors: Taub
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: André F
authors: AF
authors: Gentil
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Raony C C
authors: RC
authors: Cesar
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Marinês A
authors: MA
authors: Joaquim
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Carina Chaubet
authors: CC
authors: D'Alcante
authors: Department of Psychiatry and Behavioral Sciences, Butler Hospital and Brown Medical School, Providence, RI, USA.
authors: Nicole C
authors: NC
authors: McLaughlin
authors: Institute of Neurological Radiosurgery-Hospital Santa Paula, São Paulo, Brazil.
authors: Miguel M
authors: MM
authors: Canteras
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Roseli G
authors: RG
authors: Shavitt
authors: Center for Health Behavior Neuroscience, University of Kansas Medical Center, Kansas City, KS, USA.
authors: Cary R
authors: CR
authors: Savage
authors: Department of Psychiatry and Behavioral Sciences, Butler Hospital and Brown Medical School, Providence, RI, USA.
authors: Benjamin D
authors: BD
authors: Greenberg
authors: Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors: Georg
authors: G
authors: Norén
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Eurípedes C
authors: EC
authors: Miguel
authors: Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Antonio C
authors: AC
authors: Lopes
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020772:Internal Capsule / Q000601:surgery*; D008297:Male; D008569:Memory Disorders / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000601:surgery; D011569:Psychiatric Status Rating Scales; D016634:Radiosurgery / Q000379:methods*; D013028:Space Perception / Q000502:physiology*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
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