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Editorial commentary
Renaissance for anterior capsulotomy for obsessive–compulsive disorder?
  1. Marwan Hariz1,2
  1. 1 Clinical Neuroscience, Umea University, Umeå, Sweden
  2. 2 Movement Disorders, UCL Institute of Neurology, London, UK
  1. Correspondence to Dr Marwan Hariz, Clinical neuroscience, Umea University, Umeå, Sweden; marwan.hariz{at}umu.se

https://doi.org/10.1136/jnnp-2021-328121

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    How a new neurosurgical tool may revive an old, efficient but neglected, procedure

    Satzer et al 1 report on 18 patients with severe obsessive–compulsive disorder (OCD) who underwent anterior capsulotomy using MRI-guided laser interstitial thermal therapy (LITT). At a mean of 6 months (range: 3–51 months), the Yale-Brown Obsessive–Compulsive Scale (Y-BOCS) scores improved by 46%, and 61% of patients were considered responders (ie, with >35% amelioration of Y-BOCS scores). Neuropsychological tests and functional status showed improvement. Side effects, mostly transient apathy, were mild. Greater improvement was seen with larger lesions, but tractography and connectivity data did not show a clear relationship between the selectivity of lesioning of the ‘various and variable’ prefrontal cortex projections and the …

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    Footnotes

    • Contributors MH is the sole contributor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.

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