Skip to main content

Behavioral/Psychiatric Disorders

  • Chapter
  • First Online:
CyberKnife NeuroRadiosurgery
  • 677 Accesses

Abstract

Despite the development of effective pharmacologic and cognitive behavioral treatments for obsessive-compulsive disorder (OCD), some patients continue to be treatment-refractory and severely impaired. These patients are potential candidates for neurosurgery. Since the discovery that lesioning of the anterior limb of the internal capsule may alleviate the symptoms of OCD, stereotactic radiosurgery has been used in selected cases with promising outcomes. Radiosurgical targets and dose characteristics have evolved in recent decades with a limited number of series. CyberKnife radiosurgery will play a role in expanding the knowledge on patient selection, target, and radiation dose.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63.

    CAS  PubMed  Google Scholar 

  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Association; 2013.

    Google Scholar 

  3. Lochner C, Fineberg NA, Zohar J, van Ameringen M, Juven-Wetzler A, Altamura AC, et al. Comorbidity in obsessive-compulsive disorder (OCD): a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS). Compr Psychiatry. 2014;55(7):1513–9.

    PubMed  Google Scholar 

  4. Sharma E, Thennarasu K, Reddy YC. Long-term outcome of obsessive-compulsive disorder in adults: a meta-analysis. J Clin Psychiatry. 2014;75(9):1019–27.

    PubMed  Google Scholar 

  5. Garnaat SL, Greenberg BD, Sibrava NJ, Goodman WK, Mancebo MC, Eisen JL, et al. Who qualifies for deep brain stimulation for OCD? Data from a naturalistic clinical sample. J Neuropsychiatry Clin Neurosci. 2014;26:81–6.

    PubMed  PubMed Central  Google Scholar 

  6. Ruck C, Karlsson A, Steele JD, Edman G, Meyerson BA, Ericson K, Nyman H, Asberg M, Svanborg PL. Capsulotomy for obsessive-compulsive disorder: long- term follow-up of 25 patients. Arch Gen Psychiatry. 2008;65:914–21.

    PubMed  Google Scholar 

  7. Lopes AC, Greenberg BD, Noren G, Canteras MM, Busatto GF, de Mathis ME, Taub A, D’Alcante CC, Hoexter MQ, Gouvea FS, Cecconi JP, Gentil AF, Ferrão YA, Fuentes D, de Castro CC, Leite CC, Salvajoli JV, Duran FL, Rasmussen S, Miguel EC. Treatment of resistant obsessive-compulsive disorder with ventral capsular/ventral striatal gamma capsulotomy: a pilot prospective study. J Neuropsychiatry Clin Neurosci. 2009;21:381–92.

    CAS  PubMed  Google Scholar 

  8. Gouvea F, Lopes A, Greenberg B, Canteras M, Taub A, Mathis M, Miguel E. Response to sham and active gamma ventral capsulotomy in otherwise intractable obsessive-compulsive disorder. Stereotact Funct Neurosurg. 2010;88:177–82.

    CAS  PubMed  Google Scholar 

  9. Kondziolka D, Flickinger JC, Hudak R. Results following gamma knife radiosurgical anterior capsulotomies for obsessive compulsive disorder. Neurosurgery. 2011;68:28–32.

    PubMed  Google Scholar 

  10. Sheehan JP, Patterson G, Schlesinger D, Xu Z. Gamma knife surgery anterior capsulotomy for severe and refractory obsessive-compulsive disorder. J Neurosurg. 2013;119:1112–8.

    PubMed  Google Scholar 

  11. Lopes AC, Greenberg BD, Canteras MM, Batistuzzo MC, Hoexter MQ, Gentil AF, Pereira CA, Joaquim MA, de Mathis ME, D’Alcante CC, Taub A, de Castro DG, Tokeshi L, Sampaio LA, Leite CC, Shavitt RG, Diniz JB, Busatto G, Norén G, Rasmussen SA, Miguel EC. Gamma ventral capsulotomy for obsessive-compulsive disorder: a randomized clinical trial. JAMA Psychiatry. 2014a;71:1066–76.

    PubMed  Google Scholar 

  12. Lopes AC, Greenberg BD, Canteras MM, Batistuzzo MC, Hoexter MQ, Gentil AF, et al. Gamma ventral capsulotomy for obsessive-compulsive disorder: a randomized clinical trial. JAMA Psychiatry. 2014b;71:1066–76.

    PubMed  Google Scholar 

  13. Peker S, Yilmaz M, Sengoz M, Ulku N, Ogel K. Gamma knife radiosurgical capsulotomy for obsessive compulsive disorder. J Neurosurg. 2016;124:A1185.

    Google Scholar 

  14. Rasmussen SA, Norén G, Greenberg B, Marsland R, McLaughlin N, Malloy P, et al. Gamma ventral capsulotomy in intractable obsessive-compulsive disorder. Biol Psychiatry. 2018;84(5):355–64.

    PubMed  Google Scholar 

  15. Martinez-Alvarez R. Radiosurgery for behavioral disorders. In: Niranjan A, Lunsford LD, Kano H, editors. Leksell Radiosurgery. Prog Neurol Surg, vol. 34. Basel: Karger; 2019. p. 289–97.

    Google Scholar 

  16. Miguel EC, Lopes AC, McLaughlin NCR, Norén G, Gentil AF, Hamani C, Shavitt RG, Batistuzzo MC, Vattimo EFQ, Canteras M, De Salles A, Gorgulho A, Salvajoli JV, Fonoff ET, Paddick I, Hoexter MQ, Lindquist C, Haber SN, Greenberg BD, Sheth SA. Evolution of gamma knife capsulotomy for intactable obsessive-compulsive disorder. Mol Psychiatry. 2019;24(2):218–40.

    PubMed  Google Scholar 

  17. Greenberg BD, Rauch SL, Haber SN. Invasive circuitry-based neurotherapeutics: stereotactic ablation and deep brain stimulation for OCD. Neuropsychopharmacology. 2010;35:317–36.

    PubMed  Google Scholar 

  18. Sheth SA, Neal J, Tangherlini F, Mian MK, Gentil A, Cosgrove GR, et al. Limbic system surgery for treatment-refractory obsessive-compulsive disorder: a prospective long-term follow-up of 64 patients: clinical article. J Neurosurg. 2013;118:491–7.

    PubMed  Google Scholar 

  19. Baxi N, Bruswick A, Mazel E, Kodziolka D. Gamma Knife radiosurgery for obsessive-compulsive disorder. In: Lunsford LD, Sheehan J, editors. Intracranial stereotactic radisurgery. New York: Thieme Publishers; 2016. p. 177–82.

    Google Scholar 

  20. Mindus P, Rasmussen SA, Lindquist C. Neurosurgical treatment for refractory obsessive-compulsive disorder: implications for understanding frontal lobe function. J Neuropsychiatry Clin Neurosci. 1994;6(4):467–77.

    CAS  PubMed  Google Scholar 

  21. Lipsman N, Neimat JS, Lozano AM. Deep brain stimulation for treatment-refractory obsessive-compulsive disorder. Neurosurgery. 2007a;61(1):1–13.

    PubMed  Google Scholar 

  22. Lipsman N, Neimat JS, Lozano AM. Deep brain stimulation for treatment- refractory obsessive-compulsive disorder: the search for a valid target. Neurosurgery. 2007b;61(1):1–13.

    PubMed  Google Scholar 

  23. Gupta A, Shepard MJ, Xu Z, Maiti T, Martinez-Moreno N, Silverman J, Iorio-Morin C, Martinez-Alvarez R, Barnett G, Mathieu D, Borghei-Razavi H, Kondziolka D, Sheehan JP. An international radiosurgery research foundation multicenter retrospective study of gamma ventral capsulotomy for obsessive compulsive disorder. Neurosurgery. 2019;85(6):808–16.

    PubMed  Google Scholar 

  24. Spiegel EA, Wycis HT, Marks M, Lee A. Stereotaxic apparatus for operations on the human brain. Science. 1947;106:349–50.

    CAS  PubMed  Google Scholar 

  25. Moniz E. Essai d’un traitement chirurgical de certaines psychoses. Bull Acad Natl Med. 1936;115:385–92.

    Google Scholar 

  26. Talairach J, Hecaen H, David M. Lobotomie préfrontale limitée par électrocoagulation des fibres thalamo-frontales à leur émergence du bras antérieur de la capsule interne. Rev Neurol (Paris). 1949;83:59.

    Google Scholar 

  27. Whitty C, Duffield J, Tow P, Cairns H. Anterior cingulectomy in the treatment of mental disease. Lancet. 1952;259:475–81.

    Google Scholar 

  28. Ballantine HT Jr, Cassidy WL, Flanagan NB, Marino R Jr. Stereotaxic anterior cingulotomy for neuropsychiatric illness and intractable pain. J Neurosurg. 1967;26:488–95.

    PubMed  Google Scholar 

  29. Knight G. The orbital cortex as an objective in the surgical treatment of mental illness. The results of 450 cases of open operation and the development of the stereotactic approach. Br J Surg. 1964;51:114–24.

    CAS  PubMed  Google Scholar 

  30. Knight G. Stereotactic tractotomy in the surgical treatment of mental illness. J Neurol Neurosurg Psychiatry. 1965;28:304.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Kelly D, Richardson A, Mitchell-Heggs N, Greenup J, Chen C, Hafner R. Stereotactic limbic leucotomy. Br J Psychiatry. 1973a;123:141–8.

    CAS  PubMed  Google Scholar 

  32. Kelly D, Richardson A, Mitchell-Heggs N. Stereotactic limbic leucotomy: neurophysiological aspects and operative technique. Br J Psychiatry. 1973b;123:133–40.

    CAS  PubMed  Google Scholar 

  33. Foltz EL, White LE Jr. Pain “relief” by frontal cingulumotomy. J Neurosurg. 1962;19:89–100.

    CAS  PubMed  Google Scholar 

  34. Leksell L. Stereotaxis and radiosurgery: an operative system. Springfield: Thomas; 1971.

    Google Scholar 

  35. Rauch SL, Dougherty D, Malone D, et al. A functional neuroimaging investigation of deep brain stimulation in patients with obsessive-compulsive disorder. J Neurosurg. 2006;104(4):558–65.

    PubMed  Google Scholar 

  36. McLaughlin NCR, Nanda P, Banks GP, Miguel EC, Sheehan J, Lopes AC, et al. Gamma knife capsulotomy for intractable OCD: impact of lesion size and location. Biol Psychiatry. 2017;81:S276.

    Google Scholar 

  37. Kihlström L, Hindmarsh T, Lax I, Lippitz B, Mindus P, Lindquist C. Radiosurgical lesions in the normal human brain 17 years after gamma knife capsulotomy. Neurosurgery. 1997;41:396–402.

    PubMed  Google Scholar 

  38. Kihlström L, Guo W-Y, Lindquist C, Mindus P. Radiobiology of radiosurgery for refractory anxiety disorders. Neurosurgery. 1995;36:294–302.

    PubMed  Google Scholar 

  39. Spatola G, Martinez-Alvarez R, Martínez-Moreno N, Rey G, Linera J, Rios-Lago M, Sanz M, Gutiérrez J, Vidal P, Richieri R, Régis J. Results of Gamma Knife anterior capsulotomy for refractory obsessive-compulsive disorder: results in a series of 10 consecutive patients. J Neurosurg. 2018;131(2):376–83.

    PubMed  Google Scholar 

  40. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46:1006–11.

    CAS  PubMed  Google Scholar 

  41. Lippitz BE, Mindus P, Meyerson BA, Kihlström L, Lindquist C. Lesion topography and outcome after thermocapsulotomy or gamma knife capsulotomy for obsessive-compulsive disorder: relevance of the right hemisphere. Neurosurgery. 1999;44:452–8.

    CAS  PubMed  Google Scholar 

  42. Spofford CM, McLaughlin NCR, Penzel F, Rasmussen SA, Greenberg BD. OCD behavior therapy before and after gamma ventral capsulotomy: case report. Neurocase. 2014;20:42–5.

    PubMed  Google Scholar 

  43. Rück C, Larsson JK, Mataix-Cols D, Ljung R. A register-based 13- year to 43-year follow-up of 70 patients with obsessive–compulsive disorder treated with capsulotomy. BMJ Open. 2017;7:e013133.

    PubMed  PubMed Central  Google Scholar 

  44. Kim MC, Lee TK. Stereotactic lesioning for mental illness. Acta Neurochir Suppl. 2008;101:39–43.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sait Sirin .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sirin, S., Oysul, K. (2020). Behavioral/Psychiatric Disorders. In: Conti, A., Romanelli, P., Pantelis, E., Soltys, S., Cho, Y., Lim, M. (eds) CyberKnife NeuroRadiosurgery . Springer, Cham. https://doi.org/10.1007/978-3-030-50668-1_50

Download citation

Publish with us

Policies and ethics