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Title: Gamma ventral capsulotomy for treatment of resistant obsessive-compulsive disorder: A structural MRI pilot prospective study
Authors: Cecconia, Janaina Philippi
Lopes, Antonio Carlos
Duran, Fabio Luis de Souza
Santos, Luciana Cristina
Hoexter, Marcelo Queiroz [UNIFESP]
Gentil, Andre Felix
Canteras, Miguel Montes
Castro, Claudio Campi de
Noren, George
Greenberg, Benjamin D.
Rauch, Scott L.
Busatto, Geraldo F.
Miguel, Euripedes Constantino
Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Hosp Santa Paula
Brown Univ
Harvard Univ
Massachusetts Gen Hosp
Keywords: Obsessive-compulsive disorder (OCD)
Magnetic resonance imaging (MRI)
Voxel-based morphometry
Issue Date: 12-Dec-2008
Publisher: Elsevier B.V.
Citation: Neuroscience Letters. Clare: Elsevier B.V., v. 447, n. 2-3, p. 138-142, 2008.
Abstract: Objective: the purpose of this study was to investigate regional structural abnormalities in the brains of five patients with refractory obsessive-compulsive disorder (OCD) submitted to gamma ventral capsulotomy. Methods: We acquired morphometric magnetic resonance imaging (MRI) data before and after 1 year of radiosurgery using a 1.5-T MRI scanner. Images were spatially normalized and segmented using optimized voxel-based morphometry (VBM) methods. Voxelwise statistical comparisons between pre- and post-surgery MRI scans were performed using a general linear model. Findings in regions predicted a priori to show volumetric changes (orbitofrontal cortex, anterior cingulate gyrus, basal ganglia and thalamus) were reported as significant if surpassing a statistical threshold of p<0.001 (uncorrected for multiple comparisons). Results: We detected a significant regional postoperative increase in gray matter volume in the right inferior frontal gyri (Brodmann area 47, BA47) when comparing all patients pre and postoperatively. Conclusions: Our results support the current theory of frontal-striatal-thalamic-cortical (FSTC) circuitry involvement in OCD pathogenesis. Gamma ventral capsulotomy is associated with neurobiological changes in the inferior orbitofrontal cortex in refractory OCD patients. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
ISSN: 0304-3940
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