Bilateral Anterior Capsulotomy for Treatment-Resistant Obsessive-Compulsive Disorder.

Introduction: Ablative surgery is an intervention of last resort for treatment-resistant obsessive-compulsive disorder (TROCD). Our center has been using bilateral anterior capsulotomy (BAC) for the past 20 years for patients eligible for limbic surgery. This report details our experience with BAC for TROCD.

Ventral targeted anterior capsulotomy for treatment-resistant depression and obsessive-compulsive disorder: A treatment method with cases.

Background: Ablative surgery using bilateral anterior capsulotomy (BAC) is an option for treatment resistant depression (TRD) and obsessive-compulsive disorder (TROCD). The location and extent of the lesion within anterior limb of the internal capsule (ALIC) remains uncertain. Accumulating evidence has suggested that the lesion should be located ventrally while limiting the dorsal extent.

Tractography-Guided Anterior Capsulotomy for Major Depression and Obsessive-Compulsive Disorder: Targeting the Emotion Network.

Background: Bilateral anterior capsulotomy (BAC) is an effective surgical option for patients with treatment-resistant major depression (TRMD) and treatment-resistant obsessive-compulsive disorder (TROCD). The size of the lesion and its precise dorsal-ventral location within the anterior limb of the internal capsule (ALIC) remain undefined.

Objective: To present a method to identify the trajectories of the associative and limbic white matter pathways within the ALIC for targeting in BAC surgery.

An Analysis of Clinical Outcome and Tractography following Bilateral Anterior Capsulotomy for Depression.

Introduction: Bilateral anterior capsulotomy (BAC) is an effective surgical procedure for patients with treatment-resistant major depression (TRMD). In this work, we analyze the connectivity of the BAC lesions to identify connectivity "fingerprints" associated with clinical outcomes in patients with TRMD.

Methods: We performed a retrospective study of ten patients following BAC surgery.

Long-term neuropsychological safety of subgenual cingulate gyrus deep brain stimulation for treatment-resistant depression.

Deep brain stimulation (DBS) of the subgenual cingulate gyrus (SCG) is a promising investigational intervention for treatment-resistant depression (TRD), but long-term outcome data are limited. Serial neuropsychological evaluations, using a comprehensive battery, were conducted on four subjects with TRD prior to surgery, and up to 42 months post-operatively. Reliable change methodology suggested general stability and/or select statistically reliable improvement in cognitive abilities over time.

Bilateral anterior capsulotomy for intractable depression.

A group of eight patients with severe depression lasting 6 years or longer were treated with anterior capsulotomy and followed prospectively. Stereotactic surgery was used to produce radiofrequency lesions in the anterior limbs of both internal capsules. For all patients, there are follow-up data for at least 24 months.

Developmental topographical disorientation: case one.

Topographical disorientation is the inability to orient within the environment, usually acquired from lesions to different cerebral regions participating in the attentional, perceptual or memory functions involved during navigation. We present the first case of a patient with topographical disorientation in the absence of any structural lesion and with intact sensory and intellectual function. Experimental tests in both real and virtual environments revealed a selective impairment in forming a mental representation of the environment, namely a cognitive map.

Sexually intrusive behaviour following brain injury: approaches to assessment and rehabilitation.

Sexually intrusive behaviour, which may range from inappropriate commentary to rape, is often observed following a traumatic brain injury. It may represent novel behaviour patterns or an exacerbation of pre-injury personality traits, attitudes, and tendencies. Sexually intrusive behaviour poses a risk to staff and residents of residential facilities and to the community at large, and the development of a sound assessment and treatment plan for sexually intrusive behaviour is therefore very important.

Self-awareness after traumatic brain injury: a comparison of measures and their relationship to executive functions.

Poor awareness of deficit is common after brain injury. Recent literature has examined various tools for measurement of this phenomenon; the most widely used being self-other rating scales. Although self-other scale measures have face validity, their criterion-related validity has not been adequately demonstrated, and there is little information as to whether and how they relate to other neuropsychological measures.