BACKGROUND: As interventions for severe, treatment-refractory obsessive compulsive disorder (OCD), neurosurgical procedures are associated with only modest efficacy. The purpose of this study was to identify cerebral metabolic correlates as potential predictors of treatment response to anterior cingulotomy for OCD. METHODS: Clinical data were analyzed in the context of a retrospective design. Subjects were 11 patients who underwent stereotactic anterior cingulotomy for OCD. Symptom severity was measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and at approximately 6 months postoperative. Preoperative F-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) data were available. Statistical parametric mapping methods were used to identify loci of significant correlation between preoperative regional cerebral metabolism and postoperative reduction in Y-BOCS scores. RESULTS: One locus within right posterior cingulate cortex was identified, where preoperative metabolism was significantly correlated with improvement in OCD symptom severity following cingulotomy. Specifically, higher preoperative rates of metabolism at that locus were associated with better postoperative outcome. CONCLUSIONS: A possible predictor of treatment response was identified for patients with OCD undergoing anterior cingulotomy. Further research, utilizing a prospective design, is indicated to determine the validity and reliability of this finding. If confirmed, an index for noninvasively predicting response to cingulotomy for OCD would be of great value.
BACKGROUND: As interventions for severe, treatment-refractory obsessive compulsive disorder (OCD), neurosurgical procedures are associated with only modest efficacy. The purpose of this study was to identify cerebral metabolic correlates as potential predictors of treatment response to anterior cingulotomy for OCD. METHODS: Clinical data were analyzed in the context of a retrospective design. Subjects were 11 patients who underwent stereotactic anterior cingulotomy for OCD. Symptom severity was measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and at approximately 6 months postoperative. Preoperative F-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) data were available. Statistical parametric mapping methods were used to identify loci of significant correlation between preoperative regional cerebral metabolism and postoperative reduction in Y-BOCS scores. RESULTS: One locus within right posterior cingulate cortex was identified, where preoperative metabolism was significantly correlated with improvement in OCD symptom severity following cingulotomy. Specifically, higher preoperative rates of metabolism at that locus were associated with better postoperative outcome. CONCLUSIONS: A possible predictor of treatment response was identified for patients with OCD undergoing anterior cingulotomy. Further research, utilizing a prospective design, is indicated to determine the validity and reliability of this finding. If confirmed, an index for noninvasively predicting response to cingulotomy for OCD would be of great value.
Authors: Christy A Olson; Lisa R Hale; Nancy Hamilton; Joshua N Powell; Laura E Martin; Cary R Savage Journal: Behav Brain Res Date: 2015-08-24 Impact factor: 3.332
Authors: Michael S Okun; Giselle Mann; Kelly D Foote; Nathan A Shapira; Dawn Bowers; Utaka Springer; William Knight; Pamela Martin; Wayne K Goodman Journal: J Neurol Neurosurg Psychiatry Date: 2006-09-29 Impact factor: 10.154
Authors: Ausaf A Bari; Charles B Mikell; Aviva Abosch; Sharona Ben-Haim; Robert J Buchanan; Allen W Burton; Stephen Carcieri; G Rees Cosgrove; Pierre-Francois D'Haese; Zafiris Jeffrey Daskalakis; Emad N Eskandar; Jason L Gerrard; Wayne K Goodman; Benjamin David Greenberg; Robert E Gross; Clement Hamani; Zelma H T Kiss; Peter Konrad; Brian H Kopell; Lothar Krinke; Jean-Philippe Langevin; Andres M Lozano; Donald Malone; Helen S Mayberg; Jonathan P Miller; Parag G Patil; DeLea Peichel; Erika A Petersen; Ali R Rezai; R Mark Richardson; Patricio Riva-Posse; Tejas Sankar; Jason M Schwalb; Helen Blair Simpson; Konstantin Slavin; Paul H Stypulkowski; Tor Tosteson; Peter Warnke; Jon T Willie; Kareem A Zaghloul; Joseph S Neimat; Nader Pouratian; Sameer A Sheth Journal: J Neurol Neurosurg Psychiatry Date: 2018-01-25 Impact factor: 10.154