This article which consisted of findings of a recent large clinical case series reported in medical literature is constituted for the purpose of screening the four types of the ablative surgical treatment methods (i.e., anterior cingulotomy
, anterior capsulotomy, subcaudate tractotomy, limbic leucotomy) and their safety and efficacy in patients with TRMD.
Barcia et al (2007) and Leiphart & Valone-III (2010) recognized that the most frequent psychosurgeries are anterior capsulotomy, which have been shown beneficial for general anxiety and obsessive-compulsive disorders, and anterior cingulotomy
, which have shown improvements for depression, bipolar and schizoaffective disorders.
Surgeries such as anterior cingulotomy
, anterior capsulotomy, subcaudate tractotomy, and limbic leucotomy have been shown to effectively reduce depressive symptoms.
The rationale for targeting the SCC is mainly derived from functional neuroimaging studies that have shown MD to be associated with overactivity in this brain region (40,41,42), and the finding that disparate interventions including pharmacotherapy (43,44), repetitive transcranial magnetic stimulation (45,46), anterio cingulotomy
(47) and electroconvulsive therapy (48) ameliorate the clinical features of MD and alter the activity of the SCC.
Of note, the anterior cingulate also is the target for cingulotomy
, an established surgical treatment for OCD.
Later on, various neuroscientists around the world started patenting newer and safer modern psychosurgical procedures, such as: anterior cingulotomy
(37), subcaudate tractotomy (38), limbic leukotomy (39), anterior capsulotomy (40) and, more recently, deep brain stimulation.
DREZ lesioning, myelotomy, tractotomy, cingulotomy
, or thalamotomy, in the hope of removing the short-circuited, dysfunctional pain-generating nerves from the normal neural system, or interrupting the feedback pathway to the brain.
He was known to have been abusing opium for 5 years and was offered cingulotomy
for his drug abuse problem.
Despite that, subcaudate tractotomy, dorsal anterior cingulotomy
, anterior capsulotomy and limbic leukotomywere were still limitedly applied due to the complications such as obesity, cognitive impairment, personality changes and epilepsy.
Stereotactic radiofrequency thermal cingulotomy
for obsessive-compulsive disorder.
A procedure called stereotactic anterior cingulotomy
(SAC) was associated with significantly reduced obsessional symptoms in 48 percent of study subjects, according to a paper presented in 2012 at a meeting of the American Association of Neurological Surgeons.
The study enrolled six participants who were scheduled to undergo cingulotomy
- a procedure in which a small, precisely placed lesion is created within the ACC - to treat severe obsessive compulsive disorder (OCD) that has not responded to other types of treatment.