Efficacy and Safety of Gamma Ventral Capsulotomy for Treatment-Resistant Obsessive-Compulsive Disorder: A Single-Center Experience
World Neurosurgery, cilt.141, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 141
- Basım Tarihi: 2020
- Doi Numarası: 10.1016/j.wneu.2020.06.098
- Dergi Adı: World Neurosurgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Index Islamicus, MEDLINE, Veterinary Science Database
- Anahtar Kelimeler: Gamma ventral capsulotomy, Obsessive-compulsive disorder, Y-BOCS
- İstanbul Medipol Üniversitesi Adresli: Evet
Özet
Background: Obsessive-compulsive disorder (OCD) is a chronic disease with a lifetime prevalence of 3% and is associated with severe impairment in familial and socio-occupational functioning. Gamma ventral capsulotomy (GVC) is a treatment choice in carefully chosen patients, with few published reports. In this study, we aimed to report the efficacy and safety of GVC in 21 patients with treatment-resistant OCD. Methods: This is a retrospective single-center study. Twenty-one patients meeting the selection criteria were included. Patients were considered responders if there were ≥35% reduction in post-GVC Yale-Brown Obsessive Compulsive Scale scores and considered in remission if scores were ≤8. The mean and median clinical follow-up durations were 60.7 and 56 months, respectively (range, 38–149 months). Results: The mean baseline Yale-Brown Obsessive Compulsive Scale score of 35.7 (n = 21) decreased to 15.3 (n = 20) at 36 months follow-up evaluation (P < 0.0001). Fifteen patients (75%) achieved a full response. Of those patients, 7 (35%) were considered to be in remission. There were no partial responders, and 5 patients (25%) were classified as nonresponders. The pre-GVC mean Beck Depression Inventory–II score of 35.1 (n = 21) decreased to 13.8 (n = 20) at 36 months follow-up evaluation (P < 0.0001). Three patients (14.3%) had a transient post-GVC headache that resolved within a week, and 2 patients (9.5%) had persistent headaches that responded to 2-week oral corticosteroid treatment. A brain cyst developed after GVC in 2 patients (10%). No clinically notable abnormalities were seen on neurologic examination at any follow-up. Conclusions: Gamma ventral capsulotomy is a reasonable treatment method in select patients with treatment-resistant OCD.