Anterior Capsulotomy for Refractory Obsessive-Compulsive Disorder: A Tractography and Lesion Geometry study
Abstract Introduction: A bilateral anterior capsulotomy effectively treats refractory obsessive-compulsive disorder (OCD). We investigated the geometry of lesions and disruption of white matter pathways within the anterior limb of the internal capsule (ALIC) in patients with different outcomes. Meth...
Gespeichert in:
| Veröffentlicht in: | Stereotactic and functional neurosurgery 2023-11, Vol.101 (6), p.407-415 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 415 |
|---|---|
| container_issue | 6 |
| container_start_page | 407 |
| container_title | Stereotactic and functional neurosurgery |
| container_volume | 101 |
| creator | Li, Hongyang Yuan, Siyu Dai, Lulin Huang, Hui Lin, Zhengyu Zhan, Shikun Luo, Jie Liu, Wei Sun, Bomin |
| description | Abstract
Introduction: A bilateral anterior capsulotomy effectively treats refractory obsessive-compulsive disorder (OCD). We investigated the geometry of lesions and disruption of white matter pathways within the anterior limb of the internal capsule (ALIC) in patients with different outcomes. Methods: In this retrospective study, we analyzed data from 18 patients with refractory OCD who underwent capsulotomies. Patients were grouped into “responders” and “nonresponders” based on the percentage of decrease in the Yale-Brown Obsessive-Compulsive Scale (YBOCS) after surgery. We investigated neurobehavioral adverse effects and analyzed the overlap between lesions and the ventromedial prefrontal (vmPFC) and dorsolateral prefrontal (dlPFC) pathways. Probabilistic maps were constructed to investigate the relationship between lesion location and clinical outcomes. Results: Of the 18 patients who underwent capsulotomies, 12 were responders (>35% improvement in YBOCS), and six were nonresponders. The vmPFC pathway was more involved than the dlPFC pathway in responders (p = 0.01), but no significant difference was observed in nonresponders (p = 0.10). The probabilistic voxel-wise efficacy map showed a relationship between ventral voxels within the ALIC with symptom improvement. Weight gains occurred in 11/18 (61%) patients and could be associated with medial voxels within the ALIC. Conclusion: The optimal outcome after capsulotomy in refractory OCD is linked to vmPFC disruption in the ALIC. Medial voxels within the ALIC could be associated with weight gains following capsulotomy. |
| doi_str_mv | 10.1159/000534312 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1159_000534312</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2886597949</sourcerecordid><originalsourceid>FETCH-LOGICAL-c294t-b5d59adff47efec3afec5c120d7ac15de65d05b06580c88c31cf4178bfc9b60b3</originalsourceid><addsrcrecordid>eNpt0M1LwzAYBvAgis6Pg3eRgBc9VJOmaRtvY37CcKDzXNLkjda1S01aof-90c2dvLx5Az-eFx6Ejim5pJSLK0IIZwmj8RYa0SRmEWFZvB12QmmU0pjvoX3vPwJjSZbvoj2WiTglgo7QYrzswFXW4YlsfV_bzjYDNuH_DMZJ1Vk34FnpwfvqC6KJbdq-_lnxTeWt0-Cu8RjPf-Wbk-37gOVS4yn4yi7xPdgGupDgu14Ph2jHyNrD0fo9QK93t_PJQzSd3T9OxtNIxSLpopJrLqQ2JsnAgGIyDK5oTHQmFeUaUq4JL0nKc6LyXDGqTEKzvDRKlCkp2QE6X-W2zn724LuiqbyCupZLsL0v4jxPuchEIgK9WFHlrPcOTNG6qpFuKCgpfrotNt0Ge7qO7csG9Eb-lRnA2QospHsDtwEvd0-riKLVJqiTf9X6yjcAeIs7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2886597949</pqid></control><display><type>article</type><title>Anterior Capsulotomy for Refractory Obsessive-Compulsive Disorder: A Tractography and Lesion Geometry study</title><source>MEDLINE</source><source>Karger Journals</source><creator>Li, Hongyang ; Yuan, Siyu ; Dai, Lulin ; Huang, Hui ; Lin, Zhengyu ; Zhan, Shikun ; Luo, Jie ; Liu, Wei ; Sun, Bomin</creator><creatorcontrib>Li, Hongyang ; Yuan, Siyu ; Dai, Lulin ; Huang, Hui ; Lin, Zhengyu ; Zhan, Shikun ; Luo, Jie ; Liu, Wei ; Sun, Bomin</creatorcontrib><description>Abstract
Introduction: A bilateral anterior capsulotomy effectively treats refractory obsessive-compulsive disorder (OCD). We investigated the geometry of lesions and disruption of white matter pathways within the anterior limb of the internal capsule (ALIC) in patients with different outcomes. Methods: In this retrospective study, we analyzed data from 18 patients with refractory OCD who underwent capsulotomies. Patients were grouped into “responders” and “nonresponders” based on the percentage of decrease in the Yale-Brown Obsessive-Compulsive Scale (YBOCS) after surgery. We investigated neurobehavioral adverse effects and analyzed the overlap between lesions and the ventromedial prefrontal (vmPFC) and dorsolateral prefrontal (dlPFC) pathways. Probabilistic maps were constructed to investigate the relationship between lesion location and clinical outcomes. Results: Of the 18 patients who underwent capsulotomies, 12 were responders (>35% improvement in YBOCS), and six were nonresponders. The vmPFC pathway was more involved than the dlPFC pathway in responders (p = 0.01), but no significant difference was observed in nonresponders (p = 0.10). The probabilistic voxel-wise efficacy map showed a relationship between ventral voxels within the ALIC with symptom improvement. Weight gains occurred in 11/18 (61%) patients and could be associated with medial voxels within the ALIC. Conclusion: The optimal outcome after capsulotomy in refractory OCD is linked to vmPFC disruption in the ALIC. Medial voxels within the ALIC could be associated with weight gains following capsulotomy.</description><identifier>ISSN: 1011-6125</identifier><identifier>EISSN: 1423-0372</identifier><identifier>DOI: 10.1159/000534312</identifier><identifier>PMID: 37926091</identifier><language>eng</language><publisher>Basel, Switzerland</publisher><subject>Humans ; Images in Stereotactic and Functional Neurosurgery ; Internal Capsule - diagnostic imaging ; Internal Capsule - surgery ; Neurosurgical Procedures ; Obsessive-Compulsive Disorder - diagnostic imaging ; Obsessive-Compulsive Disorder - surgery ; Retrospective Studies ; Treatment Outcome ; Weight Gain</subject><ispartof>Stereotactic and functional neurosurgery, 2023-11, Vol.101 (6), p.407-415</ispartof><rights>2023 S. Karger AG, Basel</rights><rights>2023 S. Karger AG, Basel.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c294t-b5d59adff47efec3afec5c120d7ac15de65d05b06580c88c31cf4178bfc9b60b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37926091$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Hongyang</creatorcontrib><creatorcontrib>Yuan, Siyu</creatorcontrib><creatorcontrib>Dai, Lulin</creatorcontrib><creatorcontrib>Huang, Hui</creatorcontrib><creatorcontrib>Lin, Zhengyu</creatorcontrib><creatorcontrib>Zhan, Shikun</creatorcontrib><creatorcontrib>Luo, Jie</creatorcontrib><creatorcontrib>Liu, Wei</creatorcontrib><creatorcontrib>Sun, Bomin</creatorcontrib><title>Anterior Capsulotomy for Refractory Obsessive-Compulsive Disorder: A Tractography and Lesion Geometry study</title><title>Stereotactic and functional neurosurgery</title><addtitle>Stereotact Funct Neurosurg</addtitle><description>Abstract
Introduction: A bilateral anterior capsulotomy effectively treats refractory obsessive-compulsive disorder (OCD). We investigated the geometry of lesions and disruption of white matter pathways within the anterior limb of the internal capsule (ALIC) in patients with different outcomes. Methods: In this retrospective study, we analyzed data from 18 patients with refractory OCD who underwent capsulotomies. Patients were grouped into “responders” and “nonresponders” based on the percentage of decrease in the Yale-Brown Obsessive-Compulsive Scale (YBOCS) after surgery. We investigated neurobehavioral adverse effects and analyzed the overlap between lesions and the ventromedial prefrontal (vmPFC) and dorsolateral prefrontal (dlPFC) pathways. Probabilistic maps were constructed to investigate the relationship between lesion location and clinical outcomes. Results: Of the 18 patients who underwent capsulotomies, 12 were responders (>35% improvement in YBOCS), and six were nonresponders. The vmPFC pathway was more involved than the dlPFC pathway in responders (p = 0.01), but no significant difference was observed in nonresponders (p = 0.10). The probabilistic voxel-wise efficacy map showed a relationship between ventral voxels within the ALIC with symptom improvement. Weight gains occurred in 11/18 (61%) patients and could be associated with medial voxels within the ALIC. Conclusion: The optimal outcome after capsulotomy in refractory OCD is linked to vmPFC disruption in the ALIC. Medial voxels within the ALIC could be associated with weight gains following capsulotomy.</description><subject>Humans</subject><subject>Images in Stereotactic and Functional Neurosurgery</subject><subject>Internal Capsule - diagnostic imaging</subject><subject>Internal Capsule - surgery</subject><subject>Neurosurgical Procedures</subject><subject>Obsessive-Compulsive Disorder - diagnostic imaging</subject><subject>Obsessive-Compulsive Disorder - surgery</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Weight Gain</subject><issn>1011-6125</issn><issn>1423-0372</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0M1LwzAYBvAgis6Pg3eRgBc9VJOmaRtvY37CcKDzXNLkjda1S01aof-90c2dvLx5Az-eFx6Ejim5pJSLK0IIZwmj8RYa0SRmEWFZvB12QmmU0pjvoX3vPwJjSZbvoj2WiTglgo7QYrzswFXW4YlsfV_bzjYDNuH_DMZJ1Vk34FnpwfvqC6KJbdq-_lnxTeWt0-Cu8RjPf-Wbk-37gOVS4yn4yi7xPdgGupDgu14Ph2jHyNrD0fo9QK93t_PJQzSd3T9OxtNIxSLpopJrLqQ2JsnAgGIyDK5oTHQmFeUaUq4JL0nKc6LyXDGqTEKzvDRKlCkp2QE6X-W2zn724LuiqbyCupZLsL0v4jxPuchEIgK9WFHlrPcOTNG6qpFuKCgpfrotNt0Ge7qO7csG9Eb-lRnA2QospHsDtwEvd0-riKLVJqiTf9X6yjcAeIs7</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Li, Hongyang</creator><creator>Yuan, Siyu</creator><creator>Dai, Lulin</creator><creator>Huang, Hui</creator><creator>Lin, Zhengyu</creator><creator>Zhan, Shikun</creator><creator>Luo, Jie</creator><creator>Liu, Wei</creator><creator>Sun, Bomin</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20231101</creationdate><title>Anterior Capsulotomy for Refractory Obsessive-Compulsive Disorder: A Tractography and Lesion Geometry study</title><author>Li, Hongyang ; Yuan, Siyu ; Dai, Lulin ; Huang, Hui ; Lin, Zhengyu ; Zhan, Shikun ; Luo, Jie ; Liu, Wei ; Sun, Bomin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c294t-b5d59adff47efec3afec5c120d7ac15de65d05b06580c88c31cf4178bfc9b60b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Humans</topic><topic>Images in Stereotactic and Functional Neurosurgery</topic><topic>Internal Capsule - diagnostic imaging</topic><topic>Internal Capsule - surgery</topic><topic>Neurosurgical Procedures</topic><topic>Obsessive-Compulsive Disorder - diagnostic imaging</topic><topic>Obsessive-Compulsive Disorder - surgery</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Weight Gain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Hongyang</creatorcontrib><creatorcontrib>Yuan, Siyu</creatorcontrib><creatorcontrib>Dai, Lulin</creatorcontrib><creatorcontrib>Huang, Hui</creatorcontrib><creatorcontrib>Lin, Zhengyu</creatorcontrib><creatorcontrib>Zhan, Shikun</creatorcontrib><creatorcontrib>Luo, Jie</creatorcontrib><creatorcontrib>Liu, Wei</creatorcontrib><creatorcontrib>Sun, Bomin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stereotactic and functional neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Hongyang</au><au>Yuan, Siyu</au><au>Dai, Lulin</au><au>Huang, Hui</au><au>Lin, Zhengyu</au><au>Zhan, Shikun</au><au>Luo, Jie</au><au>Liu, Wei</au><au>Sun, Bomin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anterior Capsulotomy for Refractory Obsessive-Compulsive Disorder: A Tractography and Lesion Geometry study</atitle><jtitle>Stereotactic and functional neurosurgery</jtitle><addtitle>Stereotact Funct Neurosurg</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>101</volume><issue>6</issue><spage>407</spage><epage>415</epage><pages>407-415</pages><issn>1011-6125</issn><eissn>1423-0372</eissn><abstract>Abstract
Introduction: A bilateral anterior capsulotomy effectively treats refractory obsessive-compulsive disorder (OCD). We investigated the geometry of lesions and disruption of white matter pathways within the anterior limb of the internal capsule (ALIC) in patients with different outcomes. Methods: In this retrospective study, we analyzed data from 18 patients with refractory OCD who underwent capsulotomies. Patients were grouped into “responders” and “nonresponders” based on the percentage of decrease in the Yale-Brown Obsessive-Compulsive Scale (YBOCS) after surgery. We investigated neurobehavioral adverse effects and analyzed the overlap between lesions and the ventromedial prefrontal (vmPFC) and dorsolateral prefrontal (dlPFC) pathways. Probabilistic maps were constructed to investigate the relationship between lesion location and clinical outcomes. Results: Of the 18 patients who underwent capsulotomies, 12 were responders (>35% improvement in YBOCS), and six were nonresponders. The vmPFC pathway was more involved than the dlPFC pathway in responders (p = 0.01), but no significant difference was observed in nonresponders (p = 0.10). The probabilistic voxel-wise efficacy map showed a relationship between ventral voxels within the ALIC with symptom improvement. Weight gains occurred in 11/18 (61%) patients and could be associated with medial voxels within the ALIC. Conclusion: The optimal outcome after capsulotomy in refractory OCD is linked to vmPFC disruption in the ALIC. Medial voxels within the ALIC could be associated with weight gains following capsulotomy.</abstract><cop>Basel, Switzerland</cop><pmid>37926091</pmid><doi>10.1159/000534312</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1011-6125 |
| ispartof | Stereotactic and functional neurosurgery, 2023-11, Vol.101 (6), p.407-415 |
| issn | 1011-6125 1423-0372 |
| language | eng |
| recordid | cdi_crossref_primary_10_1159_000534312 |
| source | MEDLINE; Karger Journals |
| subjects | Humans Images in Stereotactic and Functional Neurosurgery Internal Capsule - diagnostic imaging Internal Capsule - surgery Neurosurgical Procedures Obsessive-Compulsive Disorder - diagnostic imaging Obsessive-Compulsive Disorder - surgery Retrospective Studies Treatment Outcome Weight Gain |
| title | Anterior Capsulotomy for Refractory Obsessive-Compulsive Disorder: A Tractography and Lesion Geometry study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-21T17%3A48%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Anterior%20Capsulotomy%20for%20Refractory%20Obsessive-Compulsive%20Disorder:%20A%20Tractography%20and%20Lesion%20Geometry%20study&rft.jtitle=Stereotactic%20and%20functional%20neurosurgery&rft.au=Li,%20Hongyang&rft.date=2023-11-01&rft.volume=101&rft.issue=6&rft.spage=407&rft.epage=415&rft.pages=407-415&rft.issn=1011-6125&rft.eissn=1423-0372&rft_id=info:doi/10.1159/000534312&rft_dat=%3Cproquest_cross%3E2886597949%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2886597949&rft_id=info:pmid/37926091&rfr_iscdi=true |