Magnetic Resonance-Guided Focused Ultrasound Surgery for Obsessive-Compulsive Disorders: Potential for use as a Novel Ablative Surgical Technique.
Magnetic Resonance-Guided Focused Ultrasound Surgery for Obsessive-Compulsive Disorders: Potential for use as a Novel Ablative Surgical Technique.
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DOI：
10.3389/fpsyt.2021.640832
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发表时间：
2021
影响因子：
4.7
通讯作者：
Chang JW
中科院分区：
文献类型：
--
作者：
Chang KW;Jung HH;Chang JW
由于许多科学、社会和伦理原因，使用诸如扣带回切开术和晶状体囊切开术的消融技术对精神障碍（诸如强迫症（OCD）和抑郁症）的手术治疗在历史上一直是有争议的。最近，随着健康对照组和患有此类疾病的患者使用各种功能性神经成像技术对脑功能的解剖学和神经化学底物的阐明，这些批评变得不那么有效。此外，通过使用脑深部电刺激（DBS）等新技术，并确定更精确的靶点，已在精神疾病患者中证明了有益效果和无严重并发症。然而，DBS也有许多缺点。目前，磁共振引导聚焦超声手术（MRgFUS）被用作一种微创手术方法，用于在大脑中产生精确定位的局灶性热损伤。在这里，我们回顾手术技术及其潜在的并发症，沿着与内囊前肢（ALIC）囊切开术的射频损伤和伽玛刀治疗强迫症和抑郁症。我们还讨论了与MRgFUS的ALIC囊切开术治疗医学难治性OCD和抑郁症相关的局限性和技术问题。通过本文的综述，我们希望MRgFUS能成为难治性强迫症的一种新的治疗选择。
Surgical treatment for psychiatric disorders, such as obsessive-compulsive disorder (OCD) and depression, using ablative techniques, such as cingulotomy and capsulotomy, have historically been controversial for a number of scientific, social, and ethical reasons. Recently, with the elucidation of anatomical and neurochemical substrates of brain function in healthy controls and patients with such disorders using various functional neuroimaging techniques, these criticisms are becoming less valid. Furthermore, by using new techniques, such as deep brain stimulation (DBS), and identifying more precise targets, beneficial effects and the lack of serious complications have been demonstrated in patients with psychiatric disorders. However, DBS also has many disadvantages. Currently, magnetic resonance-guided focused ultrasound surgery (MRgFUS) is used as a minimal-invasive surgical method for generating precisely placed focal thermal lesions in the brain. Here, we review surgical techniques and their potential complications, along with anterior limb of the internal capsule (ALIC) capsulotomy by radiofrequency lesioning and gamma knife radiosurgery, for the treatment of OCD and depression. We also discuss the limitations and technical issues related to ALIC capsulotomy with MRgFUS for medically refractory OCD and depression. Through this review we hope MRgFUS could be considered as a new treatment choice for refractory OCD.
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影响因子：
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作者：
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影响因子：
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DOI：
10.1176/appi.neuropsych.12090226
发表时间：
2014-12-01
影响因子：
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