Surgery for Psychiatric Disorders

Luigjes, Judy; Kwaasteniet, Bart P. de; Koning, Pelle P. de; Oudijn, Marloes; Munckhof, Pepijn van den; Schuurman, P. Richard; Denys, Damiaan

doi:10.1016/j.wneu.2012.03.009

Cited by 55 publications

(40 citation statements)

References 113 publications

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“…Nobel ödülü aldığı bu yöntemle şizofreni, bipolar bozukluk ve anksiyete bozukluğu olan 20 hastada prefrontal lobotomi yöntemini geliştirmiş ve bu uygulama kısa sürede yaygın hale gelmiştir. Ancak zaman içinde prefrontal lökotominin endikasyonlarının yeterince belirlenmemiş olması, oluşan geri dönüşümü olmayan komplikasyonlar ve psikofarmakolojideki gelişmeler nedeniyle psikocerrahi daha az yapılmaya başlanmıştır [16][17][18] .…”

Section: Psikiyatrik Bozukluklarda Cerrahinin Tarihçesiunclassified

“…Yaygın anksiyete bozukluğu ve OKB'de anterior singulotomi, bağımlılık, bipolar bozukluk, OKB, şizoaffektif bozukluk, depresyon ve şizofrenide singulotomi, Tourette sendromu için talamotomi uygulanmıştır. 1950'lere gelindiğinde ise steorotaktik psikocerrahinin yerini derin beyin stimülasyonu yöntemi almaya başlamıştır [16][17][18] .…”

Section: Psikiyatrik Bozukluklarda Cerrahinin Tarihçesiunclassified

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Tedaviye Dirençli Obsesif Kompulsif Bozuklukta Cerrahi Yaklaşımlar : Lökotomiden Gama Bıçağı Cerrahisine

Altıntaş¹

2015

Arşiv Kaynak Tarama Dergisi

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Obsessive Compulsive Disorder (OCD) is a chronic and debilitating disorder that can cause significant distress and interference with daily functioning and impairment in quality of life, social and familial relationship. Selective serotonin reuptake inhibitors and cognitive-behavioral therapy are currently viewed as the first line treatments of choice for OCD. Approximately 30-40% OCD patients fail to respond to these treatments. Anterior capsulotomy, cingulotomy, limbic leucotomy, subcaudate tractotomy are used for the treatment of refractory OCD. The studies suggested that gamma knife capsulotomy caused improvements in 55-70% refractory OCD patients. Many studies suggest that psychosurgery is a beneficial, well tolerated and safe method. This study aimed to report efficacy, adverse effects and long term effects of surgery techniques especially gamma knife and deep brain stimulation in refractory OCD patients . Key words: Obsessive-compulsive disorder, capsulotomy, gamma knife, deep brain stimulation ÖZET Obsesif Kompulsif Bozukluk (OKB), sosyal, ailesel ilişkiler, yaşam kalitesi ve günlük işlevlerde bozulma yapan, önemli derecede strese yol açan kronik ve zayıf düşürücü bir hastalıktır. Selektif serotonin geri alım inhibitörleri ve bilişsel davranışçı terapi, OKB'nin tedavisinde ilk tercih yöntemleridir. Yaklaşık olarak %30-40 OKB hastası bu tedaviye yanıt vermez. Anterior kapsülotomi, singulotomi, subkaudat traktotomi, limbik lökotomi dirençli OKB'nin cerrahi tedavisinde kullanılabilir. Araştırmalar, gama kapsulotominin %55-70 dirençli OKB hastasında düzelme sağladığını göstermiştir. Literatürde,

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Section: Psikiyatrik Bozukluklarda Cerrahinin Tarihçesiunclassified

Tedaviye Dirençli Obsesif Kompulsif Bozuklukta Cerrahi Yaklaşımlar : Lökotomiden Gama Bıçağı Cerrahisine

Altıntaş¹

2015

Arşiv Kaynak Tarama Dergisi

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“…Son estos casos, llamados resistentes, cuya sintomatología incapacitante no disminuye con el uso de tratamientos médicos tradicionales, ni con diferentes enfoques psicoterapéuticos e incluso con terapias físicas como la electroconvulsiva o la estimulación magnética transcraneal, los que se convierten en crónicos con el paso de los años (Wang, Chang, Geng, Wang & Gao, 2013;Luigjes, et al, 2013). Para que la patología psiquiátrica se considere como resistente se destacan diversos aspectos a tener en cuenta durante el proceso de evaluación, los cuales se refieren a la pobre o nula o respuesta clínica a todas las tentativas terapéuticas en sus diferentes modalidades y periodos de aplicación, a pesar de que éstas hayan sido bien llevadas.…”

Section: Introductionunclassified

“…Por otro lado, también la termoablación de estas estructuras límbicas ha demostrado alteración en la respuesta autonómica. Un procedimiento reciente que se ha estudiado es la ECP (Luigjes, et al,2013;Moreines, McClintock & Holzheimer, 2011), estrategia cuya finalidad es estimular un blanco específico dentro del cerebro, y que se lleva a cabo para tratar determinadas patologías psiquiátricas, por ejemplo, en el núcleo accumbens. Se ha demostrado (Grubert, 2011) que este tipo de intervención interrumpe, inhibe y/o estimula el "circuito de recompensa" que se inicia en el lóbulo frontal y termina en el tegmentario mesencefálico, favoreciendo la inhibición de respuestas estereotipadas disfuncionales y/o disminuyendo los síntomas depresivos en trastornos obsesivos compulsivos y en depresión.…”

Section: Introductionunclassified

Cambios en el perfil funcional de pacientes con patología psiquiátrica resistente sometidos a neurocirugía funcional estereotáctica.

Ledesma-Torres

García-Saldivar

Rodríguez-Hernández

et al. 2014

Acta. Colomb. Psicol.

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ResumenCon el objetivo de evaluar los resultados de la Neurocirugía Funcional Estereotáctica (NFE) sobre el perfil funcional de los pacientes diagnosticados con Patología Psiquiátrica Resistente (PPR), se realizó un diseño pre/post tratamiento. 13 pacientes fueron evaluados ( x = 31 ± 8 años): siete mujeres diagnosticadas con algún Trastorno de la Conducta Alimentaria Resistente (TCAR); tres mujeres diagnosticadas con Trastornos Resistentes Obsesivo Compulsivo y Depresivo (TOC y DR) y tres pacientes (dos mujeres y un hombre) diagnosticados con Depresión Resistente (DR). A estos pacientes se les aplicó la Escala de funcionamiento del paciente Eje K, la cual consta de siete subescalas, y una Escala de Evaluación de la Actividad Global (EAG) antes del tratamiento y después de éste (seis meses posteriores a la NFE). Todos los grupos diagnósticos y el total de los pacientes evaluados presentaron cambios clínicos positivos; sin embargo, sólo el grupo de TCAR mostró importantes cambios clínicos de mejoría en el perfil de funcionamiento, siendo esta diferencia estadísticamente significativa (pre Md = 56; post Md = 84; z= -2.36, p <0.05). Con la evidencia obtenida se observó que la NFE representa una opción terapéutica emergente efectiva orientada a disminuir el sufrimiento de los pacientes con PPR, así como a mejorar el nivel de funcionamiento global y por ende su calidad de vida. Todos los pacientes del estudio presentaban una condición de resistencia a tratamientos convencionales indicados, la cual había sido documentada por un equipo interdisciplinario experto. CHANGES IN THE FUNCTIONAL PROFILE OF PATIENTS WITH RESISTANT PSYCHIATRIC DISORDERS SUBJECTED TO STEREOTACTIC FUNCTIONAL NEUROSURGERY AbstractIn order to evaluate the results of the Stereotactic Functional Neurosurgery (SFN) on the functional profile of patients diagnosed with Resistant Psychiatric Pathology (RPP), a pre / post treatment design was performed. Thirteen patients were assessed ( x = 31 ± 8 years): seven women diagnosed with some type of Resistant Eating Disorder (RED); three women diagnosed with Resistant Obsessive Compulsive Disorder and Resistant Depression (TOC and RD), and three patients (two women and one man) diagnosed with Resistant Depression (RD). The Patient's Functioning Scale, axis K, consisting of seven subscales, and the Assessment of Global Activity Scale (AGAS) were applied before and after treatment (6 months after FSN).All diagnostic groups and all the patients assessed showed positive clinical changes. However, only the RED group showed important clinical improvement in the performance profile with a statistically significant difference (pre Md = 56, Md = 84 post , z = -2.36, p <0.05). With the evidence obtained it was noted that SFN represents an effective therapeutic option aimed at reducing the suffering of patients with RPP and improve their overall level of functioning and therefore their quality of life. All patients in the study had a condition indicating resistance to conventional treatments which had been documented by...

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“…In recent years, several basic science and clinical studies have significantly expanded the possible applications of deep brain stimulation from classic indications (such as Parkinson's disease) to other highly prevalent and challenging pathologies such as psychiatric disorders (obsessive-compulsive disorder, depression and addiction) [6] eating disorders (obesity and anorexia) [7] and minimally consciousness states [8], just to mention a few. Because of the unique optical, electronic and magnetic properties of graphene, the incorporation of such material to future deep brain stimulation technology is expected to open new avenues for neuromodulating strategies in functional neurosurgery.…”

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confidence: 99%

How graphene is expected to impact neurotherapeutics in the near future

Mattei¹

2014

Expert Review of Neurotherapeutics

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Surgery for Psychiatric Disorders

Cited by 55 publications

References 113 publications

Tedaviye Dirençli Obsesif Kompulsif Bozuklukta Cerrahi Yaklaşımlar : Lökotomiden Gama Bıçağı Cerrahisine

Tedaviye Dirençli Obsesif Kompulsif Bozuklukta Cerrahi Yaklaşımlar : Lökotomiden Gama Bıçağı Cerrahisine

Cambios en el perfil funcional de pacientes con patología psiquiátrica resistente sometidos a neurocirugía funcional estereotáctica.

How graphene is expected to impact neurotherapeutics in the near future

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