对抗治疗的抑郁症和强迫症障碍的腹腔向前囊切除术:一种与病例有关的治疗方法
Trevor A Hurwitz1, Josue M Avecillas-Chasin2, Nicholas M Bogod3
1Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Journal of affective disorders
|January 25, 2024
概括
双边前囊切除术 (BAC) 通过准特定的大脑区域,显示出对治疗抗性抑郁症和强迫症的希望. 这种精细的方法似乎是安全有效的,具有更广泛使用的潜力.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 精神病学是一个精神病学.
背景情况:
- 双边前囊切除术 (BAC) 是治疗耐药性抑郁症 (TRD) 和强迫症障碍 (TROCD) 的外科选择.
- 在内部囊前肢 (ALIC) 内的最佳损伤位置和范围尚未完全确定.
- 有证据表明,在有限的背部延伸的腹腔损伤焦点是最好的.
研究的目的:
- 为了研究个性化定制,腹部集中BAC的疗效和安全性.
- 针对TRD和TROCD的下部ALIC内的特定纤维通道.
主要方法:
- 术前扩散张力MRI被用于确定两个患者的ALIC纤维通道 (一个患有TRD,一个患有TROCD和TRD).
- 射频诱导的热病变是针对这些已识别的路径而创建的.
- 损伤体积在20至229mm3 (平均95mm3) 之间.
主要成果:
- 这两位患者对干预措施都有积极反应.
- 没有观察到任何显著的副作用,包括执行功能缺陷.
结论:
- 个人定制的BAC,专注于腹部ALIC,对于TRD和TROCD是有效和安全的.
- 大约10mm长的囊切除术可能在临床上是有效的.
- 磁力共振导向聚焦超声波的进步可能会增加BAC的利用.
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