Abstract
Gamma ventral capsulotomy (GVC) radiosurgery is intended to minimize side effects while maintaining the efficacy of traditional thermocoagulation techniques for the treatment of refractory obsessive–compulsive disorder (OCD). Neuropsychological outcomes are not clear based on previous studies and, therefore, we investigated the effects of GVC on cognitive and motor performance. A double-blind, randomized controlled trial (RCT) was conducted with 16 refractory OCD patients allocated to active treatment (n=8) and sham (n=8) groups. A comprehensive neuropsychological evaluation including intellectual functioning, attention, verbal and visuospatial learning and memory, visuospatial perception, inhibitory control, cognitive flexibility, and motor functioning was applied at baseline and one year after the procedure. Secondary analysis included all operated patients: eight from the active group, four from the sham group who were submitted to surgery after blind was broken, and five patients from a previous open pilot study (n=5), totaling 17 patients. In the RCT, visuospatial memory (VSM) performance significantly improved in the active group after GVC (p=0.008), and remained stable in the sham group. Considering all patients operated, there was no decline in cognitive or motor functioning after one year of follow-up. Our initial results after 1 year of follow-up suggests that GVC not only is a safe procedure in terms of neuropsychological functioning but in fact may actually improve certain neuropsychological domains, particularly VSM performance, in treatment refractory OCD patients.
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Acknowledgements
This work received financial support from the Foundation for the Support of Research in the State of São Paulo (FAPESP, Brazil) grants no. 2005/55628-08, 2008/10257-0, 2009/09949-8, 2011/21357-9 and no. 2011/51485-9) and from the National Council for Scientific and Technological Development (CNPq, Brazil, grant no. 302463/2011-9). Some results from this study have been previously presented in poster form at the 69th Meeting of the Society of Biological Psychiatry in New York, NY (2014). Clinical trial registration: Radiosurgical Treatment for Obsessive–Compulsive Disorder; ClinicalTrials.gov Identifier: NCT01004302.
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Batistuzzo, M., Hoexter, M., Taub, A. et al. Visuospatial Memory Improvement after Gamma Ventral Capsulotomy in Treatment Refractory Obsessive–Compulsive Disorder Patients. Neuropsychopharmacol 40, 1837–1845 (2015). https://doi.org/10.1038/npp.2015.33
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DOI: https://doi.org/10.1038/npp.2015.33
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