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Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness
Magnetic resonance-guided focused ultrasound (MRgFUS) anterior capsulotomy is a novel treatment option for patients with refractory obsessive compulsive disorder (OCD) or major depressive disorder (MDD). However, there is concern that lesional psychiatric surgery procedures may have adverse effects...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658970/ https://www.ncbi.nlm.nih.gov/pubmed/33177508 http://dx.doi.org/10.1038/s41398-020-01072-1 |
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author | Davidson, Benjamin Hamani, Clement Meng, Ying Baskaran, Anusha Sharma, Sachie Abrahao, Agessandro Richter, Margaret Anne Levitt, Anthony Giacobbe, Peter Lipsman, Nir Rabin, Jennifer S. |
author_facet | Davidson, Benjamin Hamani, Clement Meng, Ying Baskaran, Anusha Sharma, Sachie Abrahao, Agessandro Richter, Margaret Anne Levitt, Anthony Giacobbe, Peter Lipsman, Nir Rabin, Jennifer S. |
author_sort | Davidson, Benjamin |
collection | PubMed |
description | Magnetic resonance-guided focused ultrasound (MRgFUS) anterior capsulotomy is a novel treatment option for patients with refractory obsessive compulsive disorder (OCD) or major depressive disorder (MDD). However, there is concern that lesional psychiatric surgery procedures may have adverse effects on cognition. In this study, we examined whether MRgFUS capsulotomy causes cognitive decline in patients with psychiatric illness. Ten patients with refractory OCD (n = 5) or MDD (n = 5) underwent MRgFUS capsulotomy. Cognitive functioning was measured at baseline as well as 6 months and 12 months postoperatively, with a battery of neuropsychological tests assessing domains of executive function, memory, and processing speed. Scores were analyzed at the individual-level, and changes ≥2 standard deviations were considered clinically significant. We also examined whether changes in clinical symptoms were associated with changes in cognitive performance. At baseline intellectual functioning was in the average to high-average range for the group. Following MRgFUS capsulotomy, there were no deteriorations in cognition that reached ≥2 standard deviations at 6 or 12 months. Eight out of ten patients demonstrated a ≥2 standard deviation improvement in at least one cognitive score at 6 or 12 months postoperatively. Improvements in clinical symptoms correlated significantly with self-reported improvements in frontal lobe function (p < 0.05), but not with objective measures of cognitive functioning. To summarize, MRgFUS capsulotomy did not result in cognitive decline in this cohort of patients with refractory OCD or MDD, suggesting that this procedure can be offered to patients with a very low risk of cognitive side effects. |
format | Online Article Text |
id | pubmed-7658970 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-76589702020-11-17 Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness Davidson, Benjamin Hamani, Clement Meng, Ying Baskaran, Anusha Sharma, Sachie Abrahao, Agessandro Richter, Margaret Anne Levitt, Anthony Giacobbe, Peter Lipsman, Nir Rabin, Jennifer S. Transl Psychiatry Article Magnetic resonance-guided focused ultrasound (MRgFUS) anterior capsulotomy is a novel treatment option for patients with refractory obsessive compulsive disorder (OCD) or major depressive disorder (MDD). However, there is concern that lesional psychiatric surgery procedures may have adverse effects on cognition. In this study, we examined whether MRgFUS capsulotomy causes cognitive decline in patients with psychiatric illness. Ten patients with refractory OCD (n = 5) or MDD (n = 5) underwent MRgFUS capsulotomy. Cognitive functioning was measured at baseline as well as 6 months and 12 months postoperatively, with a battery of neuropsychological tests assessing domains of executive function, memory, and processing speed. Scores were analyzed at the individual-level, and changes ≥2 standard deviations were considered clinically significant. We also examined whether changes in clinical symptoms were associated with changes in cognitive performance. At baseline intellectual functioning was in the average to high-average range for the group. Following MRgFUS capsulotomy, there were no deteriorations in cognition that reached ≥2 standard deviations at 6 or 12 months. Eight out of ten patients demonstrated a ≥2 standard deviation improvement in at least one cognitive score at 6 or 12 months postoperatively. Improvements in clinical symptoms correlated significantly with self-reported improvements in frontal lobe function (p < 0.05), but not with objective measures of cognitive functioning. To summarize, MRgFUS capsulotomy did not result in cognitive decline in this cohort of patients with refractory OCD or MDD, suggesting that this procedure can be offered to patients with a very low risk of cognitive side effects. Nature Publishing Group UK 2020-11-11 /pmc/articles/PMC7658970/ /pubmed/33177508 http://dx.doi.org/10.1038/s41398-020-01072-1 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Davidson, Benjamin Hamani, Clement Meng, Ying Baskaran, Anusha Sharma, Sachie Abrahao, Agessandro Richter, Margaret Anne Levitt, Anthony Giacobbe, Peter Lipsman, Nir Rabin, Jennifer S. Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness |
title | Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness |
title_full | Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness |
title_fullStr | Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness |
title_full_unstemmed | Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness |
title_short | Examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness |
title_sort | examining cognitive change in magnetic resonance-guided focused ultrasound capsulotomy for psychiatric illness |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658970/ https://www.ncbi.nlm.nih.gov/pubmed/33177508 http://dx.doi.org/10.1038/s41398-020-01072-1 |
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