Departmentsof Neurosciences and Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium.
Neurosurgery. 2011 Sep;69(3):E745-51; discussion E751. doi: 10.1227/NEU.0b013e31821964d2.
State-of-the-art treatment of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) often proves ineffective. Both disorders have common features, and anterior capsulotomy is a last-resort treatment for OCD. We document the effect of bilateral anterior capsulotomy in a patient with comorbid AN and OCD.
A 38-year-old woman with life-threatening, chronic, treatment-refractory AN and OCD underwent anterior capsulotomy. Psychiatric and neuropsychological evaluations at baseline and at follow-up document the severity and progress of the case. Bilateral anterior capsulotomy resulted in normalization of eating pattern and weight and a significant decrease of food-related and overall obsessive-compulsive symptoms. Psychiatric evaluations and exposure to food cues confirmed the clinical improvement that was evident immediately after surgery and sustained at 3-month follow-up.
This case report suggests that bilateral anterior capsulotomy can be a therapeutic option for patients with comorbid AN and OCD. However, a well-controlled study is warranted.
目前对厌食症（AN）和强迫症（OCD）的治疗往往证明无效。这两种疾病有共同的特征，而前壳切开术是 OCD 的最后治疗手段。我们记录了一位同时患有 AN 和 OCD 的患者双侧前壳切开术的效果。
一位 38 岁的女性患有危及生命的、慢性的、经治疗后仍无法治愈的 AN 和 OCD，接受了前壳切开术。基线和随访时的精神科和神经心理学评估记录了该病例的严重程度和进展。双侧前壳切开术使饮食模式和体重正常化，与食物相关的和整体的强迫症状显著减少。精神科评估和接触食物线索证实了手术即刻出现的临床改善，并在 3 个月随访时持续存在。
本病例报告表明，双侧前壳切开术可能是同时患有 AN 和 OCD 的患者的一种治疗选择。然而，需要进行一项对照良好的研究。
