Anterior cingulotomy for refractory obsessive–compulsive disorder

Chang‐Hoon Kim · Jin Woo Chang · Mi-Hee Koo · J. W. Kim · Ho-Suk Suh · I. H. Park +1 more

127 citations0/0 files storedActa Psychiatrica Scandinavica

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Obsessive-Compulsive Spectrum Disorders Neurological disorders and treatments Electroconvulsive Therapy Studies

Abstract

OBJECTIVE: This study was designed to prospectively investigate the efficacy and cognitive adverse effects of stereotactic bilateral anterior cingulotomy as a treatment for refractory obsessive-compulsive (OCD) patients for 12 months. METHOD: Patients were eligible if they had severe OCD and rigorous treatments had been unsuccessful. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Clinical Global Impression (CGI) and neuropsychological tests were used to assess the efficacy and cognitive changes of cingulotomy before and 12 months after operation. RESULTS: The mean improvement rate of the Y-BOCS scores achieved from baseline was 36.0%. Out of 14 patients six met responder criteria; 35% or higher improvement rate on Y-BOCS and CGI improvement of very much or much better at 12-month follow-up. There was no significant cognitive dysfunction after cingulotomy. CONCLUSION: Anterior cingulotomy shows few cognitive adverse effects, with about half of the OCD patients demonstrating significant symptomatic improvement.

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References

1960A RATING SCALE FOR DEPRESSION 2022Diagnostic and Statistical Manual of Mental Disorders 1959THE ASSESSMENT OF ANXIETY STATES BY RATING 1989The Yale-Brown Obsessive Compulsive Scale 1981Wisconsin Card Sorting Test manual 1994Regional Cerebral Blood Flow Measured During Symptom Provocation in Obsessive-Compulsive Disorder Using Oxygen 15—Labeled Carbon Dioxide and Positron Emission Tomography 1998Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder 1999A 40-Year Follow-up of Patients With Obsessive-compulsive Disorder

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2005Obsessive–compulsive disorder: a critical review of therapeutic perspectives 2009Task-related dissociation in ERN amplitude as a function of obsessive–compulsive symptoms 2009Dysfunctional brain circuitry in obsessive–compulsive disorder: Source and coherence analysis of EEG rhythms 2004A Review of the Treatment for Refractory Obsessive-Compulsive Disorder: From Medicine to Deep Brain Stimulation 2010Diffusion tensor imaging and tract-based spatial statistics in obsessive-compulsive disorder

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