Bilateral Orbitomedial Leucotomy for Obsessive–Compulsive Disorder: A Single-Case Study Using Positron Emission Tomography
| Autor: | John Matheson, Alexandra J. Walker, Michael J. Fulham, John Sydney Smith, Julian N. Trollor, Wei Wen, Perminder S. Sachdev |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Obsessive-Compulsive Disorder medicine.medical_specialty Thalamus Neuropsychological Tests Radiosurgery Severity of Illness Index White matter 03 medical and health sciences 0302 clinical medicine Fluorodeoxyglucose F18 medicine Humans 030212 general & internal medicine medicine.diagnostic_test Remission Induction Brain General Medicine medicine.disease Psychosurgery 030227 psychiatry Surgery Psychiatry and Mental health Treatment Outcome medicine.anatomical_structure Frontal lobe Positron emission tomography Female Orbitofrontal cortex Radiology Neurosurgery Radiopharmaceuticals Psychology Anxiety disorder Tomography Emission-Computed |
| Zdroj: | Australian & New Zealand Journal of Psychiatry. 35:684-690 |
| ISSN: | 1440-1614 0004-8674 |
| DOI: | 10.1080/0004867010060519 |
| Popis: | Objective: The objective of this report is to correlate the clinical outcome of neurosurgery for obsessive–compulsive disorder (OCD) with regional cerebral glucose metabolic changes. Clinical picture: The patient was a 37-year-old female patient with severe and intractable OCD. Treatment: The patient was treated with bilateral stereotactic lesions in the frontal white matter superior to the orbito-medial cortex. Outcome: She had a remarkable improvement in her obsessive–compulsive symptoms, which was sustained up to 3 years of follow up. A positron emission tomography (PET) scan performed 18 days after surgery demonstrated an obvious reduction of metabolism in the caudate head, anterior cingulate and orbital, medial and lateral prefrontal cortices and the thalamus. At 1 year postsurgery, metabolic rate was still reduced in the anterior cingulate gyrus, caudate and thalamus compared with preoperative baseline. The patient demonstrated no long-term cognitive effects of the surgery. Conclusions: This case supports some of the cortical-subcortical circuit dysfunction models of OCD and argues for the further evaluation of neurosurgery for the treatment of a severe and intractable disorder. |
| Databáze: | OpenAIRE |
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