| Magnetic resonance imaging-guided stereotactic limbic leukotomy for treatment of intractable psychiatric disease. | |
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MedLine Citation:
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PMID: 11950407 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the efficacy and complication rates of magnetic resonance imaging-guided stereotactic limbic leukotomy for the treatment of intractable major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). METHODS: We conducted preoperative evaluations and postoperative follow-up assessments of efficacy and complications for 21 patients who underwent limbic leukotomy. Efficacy was based on physician- and patient-rated global assessments of functioning, as well as evaluations using disease-specific rating scales commonly used in studies of MDD and OCD. RESULTS: The mean time from limbic leukotomy to follow-up assessment was 26 months. On the basis of standard outcome measures, 36 to 50% of patients were considered to be treatment responders. Although permanent surgical morbidity was rare, there were reports of postoperative sequelae, including apathy, urinary incontinence, and memory complaints, which occurred in a substantial minority of cases. CONCLUSION: For this cohort of 21 patients with chronic severe MDD or OCD, who had experienced failure with an exhaustive array of previous treatments, limbic leukotomy was associated with substantial benefit for 36 to 50%. This rate is comparable to those of previous studies of limbic system surgery and indicates that limbic leukotomy is a feasible treatment option for severe, treatment-refractory MDD or OCD. Adverse consequences associated with the procedure included affective, cognitive, and visceromotor sequelae, which were generally transient. |
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Authors:
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Alonso Montoya; Anthony P Weiss; Bruce H Price; Edwin H Cassem; Darin D Dougherty; Andrew A Nierenberg; Scott L Rauch; G Rees Cosgrove |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 50 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 2002 May |
Date Detail:
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Created Date: 2002-04-12 Completed Date: 2002-06-28 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 1043-9; discussion 1049-52 Citation Subset: IM |
Affiliation:
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Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cohort Studies Depressive Disorder, Major / psychology, surgery* Feasibility Studies Female Follow-Up Studies Humans Limbic System / surgery* Magnetic Resonance Imaging* Male Memory Disorders / etiology Middle Aged Mood Disorders / etiology Obsessive-Compulsive Disorder / psychology, surgery* Psychosurgery* / adverse effects Stereotaxic Techniques* Surgery, Computer-Assisted* Time Factors Urinary Incontinence / etiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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