Journal article
An International Radiosurgery Research Foundation Multicenter Retrospective Study of Gamma Ventral Capsulotomy for Obsessive Compulsive Disorder
Neurosurgery, v 85(6), pp 808-816
01 Dec 2019
PMID: 30476294
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Obsessive compulsive disorder (OCD) across its full spectrum of severity is a psychiatric illness affecting ∼2% to 3% of the general population and results in significant functional impairment. There are few large patient series regarding Gamma ventral capsulotomy (GVC).
To evaluate clinical outcomes of severe medically refractory OCD treated with GVC.
This is an international, multicenter, retrospective cohort study. Forty patients with pre-GVC Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores ≥ 24 (indicating severe OCD) were included. GVC was performed with 1 or 2 isocenters with a median maximum dose of 135 Gy (range, 120-180 Gy). Patients were deemed "responders" to GVC if there was ≥35% reduction of follow-up Y-BOCS scores, and considered in remission if their Y-BOCS scores were ≤16. The median follow-up was 36 mo (range, 6-96 mo).
The median pre-SRS Y-BOCS score was 35 (range, 24-40). Eighteen patients (45%) were considered "responders," and 16 (40%) of them were in remission at their last follow-up. Nineteen patients (47.5%) remained stable with Y-BOCS of 33 (range, 26-36) following GVC, whereas 3 patients (7.5%) experienced worsening in Y-BOCS scores. Patients treated with 2 isocenters were more likely to have improvement in Y-BOCS score at 3 and 5 yr (P < .0005). Ten patients (25%) experienced post-GVC mood disturbance and neurological complications in 3 patients (7.5%). One patient developed radiation necrosis with edema that improved with steroids.
GVC serves as a reasonable treatment strategy for severe medical refractory OCD. Patients treated with 2 isocenters were more likely to have substantial improvement in OCD.
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Details
- Title
- An International Radiosurgery Research Foundation Multicenter Retrospective Study of Gamma Ventral Capsulotomy for Obsessive Compulsive Disorder
- Creators
- Amitabh Gupta - Cleveland ClinicMatthew J Shepard - NYU Langone HealthZhiyuan Xu - Neurological SurgeryTanmoy Maiti - Neurological SurgeryNuria Martinez-Moreno - Neurological SurgeryJoshua Silverman - Cleveland ClinicChristian Iorio-Morin - Université de SherbrookeRoberto Martinez-Alvarez - Hospital Ruber InternacionalGene Barnett - Cleveland ClinicDavid Mathieu - Université de SherbrookeHamid Borghei-Razavi - Neurological SurgeryDouglas Kondziolka - NYU Langone HealthJason P Sheehan - Neurological Surgery
- Publication Details
- Neurosurgery, v 85(6), pp 808-816
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000501737300010
- Scopus ID
- 2-s2.0-85076340268
- Other Identifier
- 991022155293904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery