Visuospatial Memory Improvement after Gamma Ventral Capsulotomy in Treatment Refractory Obsessive-Compulsive Disorder Patients

Autor(es):Mostrar menos -

Batistuzzo, Marcelo C. ^[1] ; Hoexter, Marcelo Q. ^[1] ; Taub, Anita ^[1] ; Gentil, Andre F. ^[1] ; Cesar, Raony C. C. ^[1] ; Joaquim, Marines A. ^[1] ; D'Alcante, Carina Chaubet ^[1] ; McLaughlin, Nicole C. ^{[2, 3]} ; Canteras, Miguel M. ^[4] ; Shavitt, Roseli G. ^[1] ; Savage, Cary R. ^[5] ; Greenberg, Benjamin D. ^{[2, 3]} ; Noren, Georg ^[6] ; Miguel, Euripedes C. ^[1] ; Lopes, Antonio C. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept & Inst Psychiat, Sch Med, BR-01060970 Sao Paulo - Brazil

^[2] Butler Hosp, Dept Psychiat & Behav Sci, Providence, RI 02906 - USA

^[3] Brown Med Sch, Providence, RI - USA

^[4] Hosp Santa Paula, Inst Neurol Radiosurg, Sao Paulo - Brazil

^[5] Univ Kansas, Med Ctr, Ctr Hlth Behav Neurosci, Kansas City, KS 66103 - USA

^[6] Brown Univ, Warren Alpert Med Sch, Dept Neurosurg, Providence, RI 02912 - USA

• Tipo de documento: Artigo Científico
• Fonte: NEUROPSYCHOPHARMACOLOGY; v. 40, n. 8, p. 1837-1845, JUL 2015.
• Citações Web of Science: 9

Resumo

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. (AU)

• Processo FAPESP: 11/21357-9 - Investigação de circuitos neuronais e marcadores biológicos envolvidos no transtorno obsessivo-compulsivo por meio de paradigmas comportamentais de medo e ansiedade
• Beneficiário: Eurípedes Constantino Miguel Filho
• Modalidade de apoio: Auxílio à Pesquisa - Temático
• Processo FAPESP: 08/10257-0 - Capsulotomia ventro-capsular e ventro-estriatal por raios gama no transtorno obsessivo-compulsivo: Um ensaio clínico randomizado
• Beneficiário: Antonio Carlos Lopes
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 11/51485-9 - Potencialização de inibidores da recaptura de serotonina com N-acetilcisteína no tratamento do transtorno obsessivo-compulsivo resistente: um estudo duplo-cego controlado
• Beneficiário: Roseli Gedanke Shavitt
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 09/09949-8 - Ativação cerebral associada à memória episódica verbal no Transtorno Obsessivo-Compulsivo (TOC): análise por ressonância magnética funcional
• Beneficiário: Marcelo Camargo Batistuzzo
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto