Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness.
Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness.
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DOI：
10.1038/s41398-020-01072-1
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发表时间：
2020-11-11
影响因子：
6.8
通讯作者：
Rabin JS
中科院分区：
文献类型：
--
作者：
Davidson B;Hamani C;Meng Y;Baskaran A;Sharma S;Abrahao A;Richter MA;Levitt A;Giacobbe P;Lipsman N;Rabin JS
磁共振引导聚焦超声（MRgFUS）前囊切开术是治疗难治性强迫症（OCD）或重度抑郁症（MDD）患者的一种新的治疗选择。然而，人们担心病变精神科手术可能会对认知产生不利影响。在这项研究中，我们检查了 MRgFUS 囊切开术是否会导致精神疾病患者认知能力下降。 10 名难治性 OCD (n = 5) 或 MDD (n = 5) 患者接受了 MRgFUS 囊切开术。在基线以及术后 6 个月和 12 个月时测量认知功能，并通过一系列神经心理学测试评估执行功能、记忆和处理速度等领域。在个体水平上分析分数，≥2 个标准差的变化被认为具有临床意义。我们还检查了临床症状的变化是否与认知能力的变化相关。基线时，该组的智力功能处于平均水平到高平均水平的范围内。 MRgFUS 囊切开术后，6 个月或 12 个月时认知能力未出现≥2 个标准差的恶化。术后 6 个月或 12 个月时，十分之八的患者至少在一项认知评分上表现出 ≥2 个标准差的改善。临床症状的改善与自我报告的额叶功能的改善显着相关（p<0.05），但与认知功能的客观测量无关。总而言之，MRgFUS 囊切开术并未导致这组难治性强迫症或重度抑郁症患者的认知能力下降，这表明该手术可以提供给认知副作用风险极低的患者。
Magnetic resonance-guided focused ultrasound (MRgFUS) anterior capsulotomy is a novel treatment option for patients with refractory obsessive compulsive disorder (OCD) or major depressive disorder (MDD). However, there is concern that lesional psychiatric surgery procedures may have adverse effects on cognition. In this study, we examined whether MRgFUS capsulotomy causes cognitive decline in patients with psychiatric illness. Ten patients with refractory OCD (n = 5) or MDD (n = 5) underwent MRgFUS capsulotomy. Cognitive functioning was measured at baseline as well as 6 months and 12 months postoperatively, with a battery of neuropsychological tests assessing domains of executive function, memory, and processing speed. Scores were analyzed at the individual-level, and changes ≥2 standard deviations were considered clinically significant. We also examined whether changes in clinical symptoms were associated with changes in cognitive performance. At baseline intellectual functioning was in the average to high-average range for the group. Following MRgFUS capsulotomy, there were no deteriorations in cognition that reached ≥2 standard deviations at 6 or 12 months. Eight out of ten patients demonstrated a ≥2 standard deviation improvement in at least one cognitive score at 6 or 12 months postoperatively. Improvements in clinical symptoms correlated significantly with self-reported improvements in frontal lobe function (p < 0.05), but not with objective measures of cognitive functioning. To summarize, MRgFUS capsulotomy did not result in cognitive decline in this cohort of patients with refractory OCD or MDD, suggesting that this procedure can be offered to patients with a very low risk of cognitive side effects.
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影响因子：
4.1
作者：
Fukutome, Kenji;Kuga, Yoshihiro;Nakase, Hiroyuki
通讯作者：
Nakase, Hiroyuki
影响因子：
5.4
作者：
Cabrera，Laura Y.;Brandt，Marisa;Bluhm，Robyn
通讯作者：
Bluhm，Robyn
影响因子：
6.7
作者：
Davidson, Benjamin;Meng, Ying;Lipsman, Nir
通讯作者：
Lipsman, Nir
影响因子：
2.3
作者：
Davidson, Benjamin;Hamani, Clement;Lipsman, Nir
通讯作者：
Lipsman, Nir
影响因子：
3.6
作者：
Benedict, RHB;Schretlen, D;Shpritz, B
通讯作者：
Shpritz, B