Bilateral anterior internal capsulotomy for refractory anxiety disorders
10.3760/cma.j.issn.1671-8925.2015.02.002
- VernacularTitle:双侧内囊前肢毁损术治疗难治性焦虑症
- Author:
Fafa SUN
1
;
Yixin PAN
;
Chunyan CAO
;
Yongchao LI
;
Guozhen LIN
;
Bomin SUN
;
Shikun ZHAN
Author Information
1. 上海交通大学医学院附属瑞金医院功能神经外科
- Keywords:
Anxiety disorder;
Anterior internal capsulotomy;
Magnetic resonance imaging
- From:
Chinese Journal of Neuromedicine
2015;14(2):112-115
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical effect of bilateral anterior internal capsulotomy on patients with refractory anxiety disorders.Methods Twenty-one patients with anxiety disorders,failed to pharmacological and cognitive behavior therapies for 5 years and admitted to our hospital from November 2009 to January 2012,were chosen; they received MRI-guided stereotactic bilateral anterior capsulotomy.The coordinates of the lesion target were determined under high resolution MRI directly and confirmed by intra-operative impedance test and high frequency stimulation.The lesions were received radiofrequency at 80 ℃ for 60 seconds.Pre-and post-operative mini-mental state examination (MMSE),self-rating anxiety scale (SAS),Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA) were performed by the same psychiatrists.Results In the 21 patients,8 had anxiety-free,10 had significant improvement,and 3 had no significant improvement.No serious surgery-related complications were noted.Nine patients had mild cognitive deficit and transient dysmnesia only at 1-2 weeks after operation.Personality changes,such as lack of motivation,apathy and indolence,appeared in 4 patients.Psychiatric evaluations demonstrated significant decrease of SAS,HAMD and HAMA scores after operation as compared with those before operation (P＜0.05).However,the difference of MMSE scores between pre-and post-operation was not statistically significant (P＞0.05).Conclusion MRI guided stereotactic bilateral capsulotomy is precise,safe and much an effective treatment for refractory anxiety disorders,whcih is promising to alleviate the symptoms of anxiety and depression,as well as improving the quality of life.
