Increased apathy post-interstitial laser capsulotomy for refractory obsessive-compulsive disorder

Area of Science:

• Neurosurgery
• Psychiatry
• Neurology

Background:

• Laser interstitial thermal therapy (LITT) is effective for refractory obsessive-compulsive disorder (OCD).
• Previous ablative procedures sometimes resulted in increased patient apathy.
• This study investigates apathy changes after M-LITT anterior capsulotomy for OCD.

Purpose of the Study:

• To assess patient-reported changes in apathy, disinhibition, depression, and executive dysfunction after M-LITT anterior capsulotomy for OCD.
• To evaluate the safety and efficacy of M-LITT in managing OCD symptoms and associated psychological effects.

Main Methods:

• Ten OCD patients underwent M-LITT anterior capsulotomy.
• Patients completed pre- and post-operative assessments of OCD, apathy, disinhibition, executive function, and depression.
• Reliable Change Index (RCI) and percentage change in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores were used for analysis.

Main Results:

• Over 65% of patients showed partial or full OCD symptom response.
• Sixty percent of patients reported increased apathy post-M-LITT.
• Depression symptoms decreased in over half of patients, while disinhibition and executive function remained stable.
• Apathy increased in some patients irrespective of depression changes or OCD treatment response.

Conclusions:

• M-LITT anterior capsulotomy is effective for OCD symptom reduction.
• A significant proportion of patients experience increased apathy post-procedure, warranting further investigation.
• Future research should explore the relationship between lesion location, surgical parameters, and apathy development.