Lesion Topography and Outcome after Thermocapsulotomy or Gamma Knife Capsulotomy for Obsessive-Compulsive Disorder: Relevance of the Right Hemisphere

Lippitz, Bodo; Mindus, Per; Meyerson, Björn A.; Kihlström, Lars; Lindquist, Christer

doi:10.1097/00006123-199903000-00005

Cited by 161 publications

(102 citation statements)

References 24 publications

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“…In severe OCD cases, where all other available therapeutic approaches have been tried without success, neurosurgery may be a treatment option. Only unblinded studies are available that showed improvements after Á bilateral anterior capsulotomy (Lippitz et al 1999; Ló pez Ibor and Ló pez-Ibor Aliñ o 1975; Mindus et al 1990Mindus et al , 1999Oliver et al 2003;Rü ck, 2006;Skoog and Skoog 1999), Á cingulotomy (Baer et al 1995;Dougherty et al 2002;Jenike et al 1991a;Kim et al 2003;Richter et al 2004), Á limbic leucotomy (Cumming et al 1995;Hay et al 1993;Montoya et al 2002;Sachdev and Hay 1995), Á subcaudate tractotomy (Hodgkiss et al 1995;Woerdeman et al 2006) or Á thalamotomy/pallidotomy (Jeanmonod et al 2003).…”

Section: Repetitive Transcranial Magnetic Stimulation (Rtms)mentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

711

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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Section: Repetitive Transcranial Magnetic Stimulation (Rtms)mentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

711

410

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“…164 The idea for treatment of depression with DBS in the VC/VS came from reports of stimulation for OCD, where patients' depression and anxiety simultaneously improved. 78,210 In an initial trial, 8 of 10 patients whose primary diagnosis of OCD had comorbid clinical depression, and from an average HDRS baseline of 21.1, by 36 months the average score had dropped to 15.4.…”

Section: Ventral Capsule and Ventral Striatummentioning

confidence: 99%

Deep brain stimulation for psychiatric disorders: where we are now

Cleary

Ozpinar

Raslan

et al. 2015

FOC

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Fossil records showing trephination in the Stone Age provide evidence that humans have sought to influence the mind through physical means since before the historical record. Attempts to treat psychiatric disease via neurosurgical means in the 20th century provided some intriguing initial results. However, the indiscriminate application of these treatments, lack of rigorous evaluation of the results, and the side effects of ablative, irreversible procedures resulted in a backlash against brain surgery for psychiatric disorders that continues to this day. With the advent of psychotropic medications, interest in invasive procedures for organic brain disease waned. Diagnosis and classification of psychiatric diseases has improved, due to a better understanding of psychiatric patho-physiology and the development of disease and treatment biomarkers. Meanwhile, a significant percentage of patients remain refractory to multiple modes of treatment, and psychiatric disease remains the number one cause of disability in the world. These data, along with the safe and efficacious application of deep brain stimulation (DBS) for movement disorders, in principle a reversible process, is rekindling interest in the surgical treatment of psychiatric disorders with stimulation of deep brain sites involved in emotional and behavioral circuitry. This review presents a brief history of psychosurgery and summarizes the development of DBS for psychiatric disease, reviewing the available evidence for the current application of DBS for disorders of the mind.

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“…As had been previously suggested with thermocapsulotomies and Gamma Knife capsulotomies, response rates improved as the target was shifted posteriorly, to within a millimeter of the posterior border of the anterior commissure. 41 This migration of the target site reduced the stimulation energies required for eliciting a clinical response, possibly because the fiber bundle being targeted grows more compact as it courses posteriorly. 65 The refinement in target selection was attended by an increase in the percentage of patients manifesting ≥ 35% reductions in Y-BOCS scores (from 33% to 75%).…”

Section: Target 1: the Alic And Vc/vsmentioning

confidence: 99%

Deep brain stimulation for obsessive-compulsive disorder: past, present, and future

Mian

Campos

Sheth

et al. 2010

FOC

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Obsessive-compulsive disorder (OCD) is a psychiatric illness that can lead to chronic functional impairment. Some patients with severe, chronic OCD have been treated with ablative neurosurgical techniques over the past 4 decades. More recently, deep brain stimulation (DBS) has been investigated as a therapy for refractory OCD, and the procedure was granted a limited humanitarian device exemption by the FDA in 2009. In this article, the authors review the development of DBS for OCD, describe the current understanding of the pathophysiological mechanisms of the disorder and how the underlying neural circuits might be modulated by DBS, and discuss the clinical studies that provide evidence for the use of this evolving therapy. The authors conclude with suggestions for how a combined basic science and translational research approach could drive the understanding of the neural mechanisms underlying OCD as well as the clinical effectiveness of DBS in the setting of recalcitrant disease.

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Lesion Topography and Outcome after Thermocapsulotomy or Gamma Knife Capsulotomy for Obsessive-Compulsive Disorder: Relevance of the Right Hemisphere

Abstract: The current anatomic long-term analysis after thermocapsulotomy or gamma knife capsulotomy for obsessive-compulsive disorder reveals common topographic features within the right-sided anterior limb of the internal capsule independent of treatment modality.

Cited by 161 publications

References 24 publications

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Deep brain stimulation for psychiatric disorders: where we are now

Deep brain stimulation for obsessive-compulsive disorder: past, present, and future

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