Surgical Approaches in Refractory Obsessive Compulsive Disorder: From Leukotomy to Gamma Knife Surgery

Yıl 2015, Cilt: 24 Sayı: 2, 239 - 250, 05.03.2015

Ebru Altıntaş

https://doi.org/10.17827/aktd.29712

Öz

Obsessive Compulsive Disorder (OCD) is a chronic and debilitating disorder that can cause significant distress and interference with daily functioning and impairment in quality of life, social and familial relationship. Selective serotonin reuptake inhibitors and cognitive-behavioral therapy are currently viewed as the first line treatments of choice for OCD. Approximately 30-40% OCD patients fail to respond to these treatments. Anterior capsulotomy, cingulotomy, limbic leucotomy, subcaudate tractotomy are used for the treatment of refractory OCD. The studies suggested that gamma knife capsulotomy caused improvements in 55-70% refractory OCD patients. Many studies suggest that psychosurgery is a beneficial, well tolerated and safe method. This study aimed to report efficacy, adverse effects and long term effects of surgery techniques especially gamma knife and deep brain stimulation in refractory OCD patients .

Anahtar Kelimeler

Obsessive-compulsive disorder, capsulotomy, gamma knife, deep brain stimulation

Tedaviye Dirençli Obsesif Kompulsif Bozuklukta Cerrahi Yaklaşımlar : Lökotomiden Gama Bıçağı Cerrahisine

Öz

Obsesif Kompulsif Bozukluk(OKB) obsesyon ve kompulsiyonlarla karakterize yaygın bir ruhsal bozukluktur. Obsesif Kompulsif Bozukluk, sosyal, ailesel ilişkiler, yaşam kalitesi ve günlük işlevlerde bozulma yapan, önemli derecede strese yol açan kronik ve zayıf düşürücü bir hastalıktır. Selektif seratonin geri alım inhibitörleri ve bilişsel davranışçı terapi, OKB’nin tedavisinde ilk tercih yöntemleridir. Yaklaşık olarak %30-40 OKB hastası bu tedaviye yanıt vermez. Anterior kapsülotomi, singulotomi, subkaudat traktotomi, limbik lökotomi dirençli OKB’nin cerrahi tedavisinde kullanılabilir. Araştırmalar, gama kapsulotominin %55-70 dirençli OKB hastasında düzelme sağladığını göstermiştir. Literatürde, psikiyatrik cerrahinin faydalı, iyi tolere edilen ve güvenilir bir yöntem olduğu bazı araştırmalarda sunulmuştur. Bu derlemenin amacı, tedaviye dirençli OKB hastalarında kullanılan cerrahi yöntemlerin özellikle gama bıçağı kapsülotomi ve derin beyin stimülasyonunun etkinliği, yan etkileri ve uzun dönem etkilerini sunmaktır.

Anahtar Kelimeler

Obsesif-kompulsif bozukluk, kapsülotomi, gama bıçağı, derin beyin stimülasyonu

Kaynakça

• Karno M, Golding JM, Sorenson SB, Burnam MA. The epidemiology of obsessive–compulsive disorder in five US communities. Arch Gen Psychiatry. 1988;45:1094–9.
• Rasmussen SA, Eisen JL. Epidemiology and differential diagnosis of obsessive compulsive disorder. J Clin Psychiatry. 1994;55;11-4.
• Weissman MM, Bland RC, Canino GJ, Greenwald S, Hwu HG, Lee CK et al. The cross national epidemiology of obsessive compulsive disorder. The Cross National Collaborative Group. J Clin Psychiatry. 1994;55:5-10,
• Eisen JL, Mancebo MA, Pinto A, Colesb ME, Paqano ME, Stout R et al. Impact of obsessive- compulsive disorder on quality of life. Compr Psychiatry. 2006;47:270–5.
• Srivastava S, Bhatia MS, Thawani R, Jhanjee A. Quality of life in patients with obsessive compulsive disorder: a longitudinal study from India. Asian J Psychiatry. 2011;4:178-82.
• Rosa AC, Diniz JB, Fossaluza V, Torres AR, Fontenelle LF, De Mathis AS et al. Clinical correlates of social adjustment in patients with obsessive-compulsive disorder. J Psychiatr Res. 2012;46:1286- 92.
• Steketee G. Disability and family burden in obsessive- compulsive disorder. Can J Psychiatry. 1997;42:919–28.
• Koran, LM, Thienemann ML, Davenport R. Quality of life for patients with obsessive compulsive disorder. Am J Psychiatry. 1996;153:783–8.
• Karno M, Golding JM, Sorenson SB, Burnam MA. The epidemiology of obsessive-compulsive disorder in five US Communities. Arch Gen Psychiatry. 1988;45:1094-9.
• Hollander E, Kwon JH, Stein DJ, Broatch J, Rowland CT, Himelein CA. Obsessive-compulsive and spectrum disorders: overview and quality of life issues. J Clin Psychiatry. 1996;8:3–6.
• Eisen JL, Mancebo MA, Pinto A, Coles ME, Pagano ME, Stauf R et al. Impact of obsessive compulsive disorder on quality of life.Comp Psychiatry. 2006;47:270-5.
• Rasmussen SA, Eisen JL. Treatment strategies for chronic and refractory obsessive compulsive disorder. J Clin Psychiatry. 1997;58:9-13.
• Pallanti S, Quercioli L. Treatment-refractory obsessive-compulsive disorder: methodological issues,operational definitions and therapeutic lines. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30:400-12.
• Husted DS, Shapira NA. A review of the treatment for refractory obsessive-compulsive disorder: from medicine to deep brain stimulation. CNS Spectr. 2004;9:833-47.
• Murray CJL, Lopez AD. The Global Burden of Disease. Boston (MA), Harvard University Press, 1996.
• Luigjes J, de Kwaasteniet BP, de Koning PP, Oudijn MS, van den Munckhof P, Schuurman PR et al. Surgery for psychiatric disorders . World Neurosurg. 2013;80:17-28.
• Lapidus KA, Kopell BH, Ben-Haim S, Rezai AR, Goodman WK. History of psychosurgery: a psychiatrist's perspective. World Neurosurg. 2013;80:S27.E16
• Mashour GA, Walker EE, Martuza RL. Psychosurgery: past, present, and future. Brain Res Brain Res Rev. 2005;48:409-19.
• Nuttin B, Wu H, Mayberg H, Hariz M, Gabriëls L, Galert T et al. Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders.J Neurol Neurosurg Psychiatry. 2014;85:1003- 8.
• Lopes AC, Greenberg BD, Noren G, Canteras MM, Busatto GF, de Mathis ME et al. Treatment of resistant obsessive-compulsive disorder with ventral capsular/ventral striatal gamma capsulotomy: a pilot prospective study. J Neuropsychiatry Clin Neurosci. 2009;21:381-92.
• Polosan M, Millet B, Bougerol T, Olie JP, Devaux B. Psychosurgical treatment of malignant OCD: three case-reports. Encephale. 2003;29:545-52.
• Taub A, Lopes AC, Fuentes D, D’Alcante CC, de Mathis ME, Canteras MM at al. Treatment of resistant obsessive-compulsive disorder with ventral capsular/ventral striatal gamma capsulotomy: a pilot prospective study. J Neuropsychiatry Clin Neurosci. 2009;21:381-92.
• Del Casale A, Kotzalidis GD, Rapinesi C, Serata D, Ambrosi E, Simonetti A et al. Functional neuroimaging in obsessive compulsive disorder. Neuropsychobiology. 2011;64:61-85.
• Zhan S, Liu W, Li D, Pan S, Pan Y, Li Y et al. Long-term follow-up of bilateral anterior capsulotomy in patients with refractory obsessive-compulsive disorder. Clin Neurol Neurosurg. 2014;119:91-5.
• Liu K, Zhang H, Liu C, Guan Y, Lang L, Cheng Y et al. Stereotactic treatment of refractory obsessive compulsive disorder by bilateral capsulotomy with 3 years follow-up. J Clin Neurosci. 2008;15:622-9.
• D'Astous M, Cottin S, Roy M, Picard C, Cantin L. Bilateral stereotactic anterior capsulotomy for obsessive-compulsive disorder: long-term follow-up. J Neurol Neurosurg Psychiatry. 2013;84:1208-13. .
• Dougherty DD, Baer L, Cosgrove GR, Cassem EH, Price BH, Nierenberg AA et al. Prospective long- term follow-up of 44 patients who received cingulotomy for treatment-refractory obsessive- compulsive disorder. Am J Psychiatry. 2002;159:269-75.
• Kim CH, Chang JW, Koo MS, Kim JW, Suh HS, Park IH et al. Anterior cingulotomy for refractory obsessive-compulsive disorder. Acta Psychiatr Scand. 2003;107:283-90.
• Jenike MA, Baer L, Ballantine T, Martuza RL, Tynes S, Giriunas I et al. Cingulotomy for refractory obsessive-compulsive disorder. A long-term follow-up of 33 patients. Arch Gen Psychiatry. 1991;48:548-55.
• Baer L, Rauch SL, Ballantine HT Jr, Martuza R, Cosgrove R, Cassem E et al. Cingulotomy for intractable obsessive-compulsive disorder. Prospective long-term follow-up of 18 patients. Arch Gen Psychiatry. 1995;52:384-392.
• Jung HH, Kim CH, Chang JH, Park YG, Chung SS, Chang JW. Bilateral anterior cingulotomy for refractory obsessive-compulsive disorder: Long-term follow-up results. Stereotact Funct Neurosurg. 2006;84:184-9.
• Rück C, Karlsson A, Steele JD, Edman G, Meyerson BA, Ericson K et al. Capsulotomy for obsessive- compulsive disorder: long-term follow-up of 25 patients. Arch Gen Psychiatry. 2008;65:914-21.
• Lipsman N, Neimar JS, Lozano AM. Deep brain stimulation for treatment refractory obsessive- compulsive disorder: the search for a valid target. Neurosurgery. 2007;61:1-13.
• Talairach JH, H. David, M: Prefrontal lobotomies by electrocoagulation of the thalamo-frontal fibers at the anterior limb of the internal capsule. Proceedings IV Congres Neurologique International. Paris, France; 1949.
• Leksell L, Leksell D, Schwebel J. Stereotaxis and nuclear magnetic resonance. J Neurol Neurosurg Psychiatry. 1985;48;14-8.
• Abelson JL, Curtis GC, Sagher O, Albucher RC, Harrigan M, Taylor SF et al. Deep brain stimulation for refractory obsessive compulsive disorder. Biol Psychiatry. 2005;57:510-6.
• Greenberg BD, Gabriels LA, Malone DA Jr, Rezai AR, Friehs GM, Okun MS et al. Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience. Mol Psychiatry. 2010;15:64-79.
• Mallet L, Polosan M, Jaafari N, Baup N, Welter ML, Fontaine D et al. STOC Study Group. Subthalamic nucleus stimulation in severe obsessive-compulsive disorder. N Engl J Med. 2008;359:2121-34.
• Goodman WK, Foote KD, Greenberg BD, Ricciuti N, Bauer R, Ward H et al. Deep brain stimulation for intractable obsessive compulsive disorder: pilot study using a blinded, staggered-onset design. Biol Psychiatry. 2010;67:535-42.
• Denys D, Mantione M, Figee M, van den Munckhof P, Koerselman F, Westenberg H et al. Deep brain stimulation of the nucleus accumbens for treatment-refractory obsessive-compulsive disorder. Arch Gen Psychiatry. 2010;67:1061-8.
• Tsai HC, Chang CH, Pan JI, Hsieh HJ, Tsai ST, Hung HY et al. Pilot study of deep brain stimulation in refractory obsessive-compulsive disorder ethnic Chinese patients. Psychiatry Clin Neurosci. 2012;66:303-12. .
• Huff W, Lenartz D, Schormann M, Lee SH, Kuhn J, Koulousakis A et al..Unilateral deep brain stimulation of the nucleus accumbens in patients with treatment-resistant obsessive-compulsive disorder: Outcomes after one year. Clin Neurol Neurosurg. 2010;112:137-43.
• Franzini A, Messina G, Gambini O, Muffatti R, Scarone S, Cordella R et al: Deep-brain stimulation of the nucleus accumbens in obsessive-compulsive disorder: clinical, surgical and electrophysiological considerations in two consecutive patients. Neurol Sci. 2010;31:353-9.
• Lippitz BE, Mindus P, Meyerson BA, Kihlstrom L, Lindquist C. Lesion topography and outcome after thermocapsulotomy or gamma knife capsulotomy for obsessive-compulsive disorder: relevance of the right hemisphere. Neurosurgery. 1999; 44:452-8.
• Kondziolka D, Flickinger JC, Hudak R. Results following gamma knife radiosurgical anterior capsulotomies for obsessive compulsive disorder. Neurosurgery. 2011;68:28-32.
• Sheehan JP, Patterson G,Schlesinger D, Xu Z. Gamma knife surgery anterior capsulotomy for severe and refractory obsessive compulsive disorder. J Neurosurg. 2013;119:1112-8.
• Tripathi M, Mukherjee K, Chhabra R, Radotra I, Psıngh A, Radotra B. Gamma Knife for obsessive- compulsive disorder: can it be detrimental? Turk Neurosurg. 2014;24:583-6.
• Lopes AC, Greenberg BD, Canteras MM, Batistuzzo MC, Hoexter MQ, Gentil AF et al. Gamma ventral capsulotomy for obsessive-compulsive disorder: a randomized clinical trial. JAMA Psychiatry. 2014;71:1066-76.
• Feldman RP, Goodrich JT: Psychosurgery: a historical overview. Neurosurgery. 2001;48:647-57.
• Correspondence Address / Yazışma Adresi