伽玛刀放射外科治疗难治性强迫症的疗效
Treatment Outcomes of Gamma-Knife Radio Surgery in Refractory Obsessive-Compulsive Disorder.
作者信息
Ekmekçi Ertek İrem, Uçar Önder, Emre Yaman Mesut, Hakan Emmez Ömer, Candansayar Selçuk
机构信息
Department of Psychiatry, Gazi University School of Medicine, Ankara, Turkey.
Department of Neurosurgery, Gazi University School of Medicine, Ankara, Turkey.
出版信息
Psychiatry Clin Psychopharmacol. 2021 Dec 1;31(4):401-407. doi: 10.5152/pcp.2021.21223. eCollection 2021 Dec.
BACKGROUND
Obsessive-compulsive disorder (OCD) is a common disease that has negative effects on functionality, and 10% of the patients do not respond to first-line treatments. Gamma-knife radiosurgery (GKRS) has been used in patients with treatment-resistant OCD, but the data on long-term outcomes are still unsatisfactory.
METHODS
In this study, 12 patients who underwent GKRS between 2005 and 2020 were evaluated retrospectively. Anterior capsulotomy was performed using two 4-mm isocenters at the midputaminal point of the anterior limb of the internal capsule on each side with a maximum radiation dose of 140-180 Gy. Patients were followed up with the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), Montgomery-Asberg Depression Rating Scale (MADRS), and Brief Psychiatric Rating Scale (BPRS) on the first, third, and sixth months.
RESULTS
After the procedure, a 35% reduction was observed in the overall Y-BOCS scores, and full response rate was 50%. There was a 49.5% decrease in the MADRS scores and a 57.8% decrease in the BPRS.
CONCLUSION
GKRS is an effective and non-invasive procedure with favorable side effects in treatment-resistant OCD with selected patients.
背景
强迫症（OCD）是一种对功能有负面影响的常见疾病，10%的患者对一线治疗无反应。伽玛刀放射外科手术（GKRS）已用于治疗难治性强迫症患者，但长期疗效数据仍不令人满意。
方法
本研究回顾性评估了2005年至2020年间接受GKRS治疗的12例患者。在内囊前肢的中豆状核点两侧使用两个4毫米等中心进行前囊切开术，最大辐射剂量为140-180 Gy。在第1、3和6个月使用耶鲁-布朗强迫症量表（Y-BOCS）、蒙哥马利-阿斯伯格抑郁量表（MADRS）和简明精神病评定量表（BPRS）对患者进行随访。
结果
术后，Y-BOCS总分下降了35%，完全缓解率为50%。MADRS评分下降了49.5%，BPRS评分下降了57.8%。
结论
对于部分难治性强迫症患者，GKRS是一种有效且无创的治疗方法，副作用较小。
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