Late local and remote structural changes after capsulotomy for obsessive compulsive disorder.
Late local and remote structural changes after capsulotomy for obsessive compulsive disorder.
复制标题
强迫症囊切开术后晚期局部和远端结构变化。
DOI：
10.1159/000100280
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发表时间：
1994
影响因子：
1.7
通讯作者：
S. Gebarski
中科院分区：
文献类型：
--
作者：
J. Taren;G. Curtis;S. Gebarski
立体定向尾状核下囊切开术（SC）用于治疗医学上难治性强迫症（OCD）。虽然已经观察到临床改善，但在这种生物学疾病中缺乏SC后结构相关性。我们的研究提供了影像学证据，局部和远处的结构改变，可能有一个重要的作用，强迫症的表现。5例接受SC治疗的OCD患者接受了MR成像，用于SC前计划、SC后早期（1-7天）评估和晚期（5-12个月）随访。内囊前肢、尾状头、第三脑室、乳头体、丘脑和海马结构的体积进行了数字计算。比较了每一系列成像研究的结果。SC后5-12个月，所有患者均显示内囊、尾状核头、丘脑的前肢体积减小，第三脑室体积增加（反映丘脑/尾状核萎缩）。2-5患者海马结构体积减少。SC后这些结构的体积减少，有些距离立体定向病变很远，表明内囊前肢、尾状核/丘脑核以及可能的苍白球和边缘系统的相互关系对于强迫症及其变体的表现是必要的。
Stereotactic subcaudate capsulotomy (SC) is used to treat medically intractable obsessive compulsive disorders (OCD). Although clinical improvement has been observed, post-SC structural correlates are lacking in this biological disorder. Our study provides imaging evidence for local and distant alterations in structures which may have an important role in the manifestations of OCD. Five OCD patients treated with SC received MR imaging for pre-SC planning, early (1-7 days) post-SC assessment, and late (5-12 months) follow-up. The volumes of the anterior limb of the internal capsules, caudate heads, third ventricle, mamillary bodies, thalami, and hippocampal formations were digitally computed. Volumes from each of the serial imaging studies were compared. At 5-12 months post-SC, all patients showed reduction in volume of the anterior limbs of the internal capsules, caudate heads, thalami, and increased volume of the third ventricle (reflecting thalamic/caudate atrophy). 2-5 patients showed reduction in hippocampal formation volume. The post-SC reduction in volume of these structures, some far distant to the stereotactic lesion, suggests that the interrelationships of the anterior limb of the internal capsule, the caudate/thalamic nuclei, and possibly the pallidal and limbic systems are necessary for the manifestations of OCD and their variants.