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| |  Gamma Knife Ventral Capsulotomy for Intractable OCD Safe, but Further Study Needed: Presented at ADAA By Liz Meszaros BALTIMORE, Md -- March 8, 2010 -- Gamma knife ventral capsulotomy for otherwise intractable obsessive compulsive disorder (OCD) was not associated with group-level cognitive decrements, according to data presented here at the Anxiety Disorders Association of America 30th Annual Conference (ADAA). In addition, results showed that this procedure brought about improvements in confrontation naming, tactile perception and motor speed, nonverbal immediate and delayed memory, and verbal short delay recall. “In this study, we concentrated on the safety of this procedure in patients with severe intractable OCD of 30-years’ duration or more,” said Nicole C.R. McLaughlin, MD, Department of Psychiatry and Human Behavior, Butler Hospital and Alpert School of Medicine, Brown University, Providence, Rhode Island, on March 5. “We now know that gamma knife ventral capsulotomy is safe, but we have a long way to go as to determining how and why patients need capsulotomies. We must learn now how to tailor it to individual patients.” For the study, 34 patients with severe, chronic OCD (mean baseline Yale-Brown Obsessive-Compulsive Scale score = 33.59) were treated at the New England Gamma Knife Center, Providence, Rhode Island, with gamma knife ventral capsulotomy. The procedure was performed with the Leksell gamma knife, which allows lesions to be placed in the brain stereotactically without craniotomy, and thus reduces the risk of infection, haemorrhage, or seizure, when compared with open procedures. Patients underwent comprehensive neuropsychological testing before treatment and at multiple points after radiosurgery. Repeated measures t-testing showed no significant declines in any neuropsychological measure. Yale-Brown Obsessive-Compulsive Scale OCD severity declined from the extreme to the severe range (P = .000), but symptom improvement is not anticipated to maximise for approximately 2 years. Anxiety and depression also declined from moderate to mild-moderate on the Beck Anxiety Inventory; from mild-moderate to mild on the Hamilton Anxiety Rating Scale; from moderate to mild on the Beck Depression Inventory; and from very severe to moderate-severe on the Hamilton Depression Rating Scale. Significant improvements occurred after a mean follow-up of 8.7 months in the Boston Naming Test (baseline mean 52.27 vs 53.67 at follow-up; P = .001), tactual performance testing in both dominant and non-dominant hands (P = .008 and P = .001, respectively), Rey Figure Immediate Recall and Delayed (P = .002 for both), and California Verbal Learning Test for short delay free recall (P = .038). [Presentation title: Initial Follow-up of Gamma Knife Ventral Capsulotomy for Treatment of Obsessive-Compulsive Disorder. Abstract 16]
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