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Current Behavioral Neuroscience Reports
Erschienen in: Current Behavioral Neuroscience Reports 2/2015

01.06.2015 | Neuromodulation (D Dougherty, Section Editor)

Ablative Limbic System Surgery: Review and Future Directions

verfasst von: Saurabh Sinha, Robert A. McGovern, Charles B. Mikell, Garrett P. Banks, Sameer A. Sheth

Erschienen in: Current Behavioral Neuroscience Reports | Ausgabe 2/2015

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Abstract

The limbic system is a network of interconnected brain regions regulating emotion, memory, and behavior. Pathology of the limbic system can manifest as psychiatric disease, including obsessive-compulsive disorder and major depressive disorder. For patients with these disorders who have not responded to standard pharmacological and cognitive-behavioral therapy, ablative surgery is a neurosurgical treatment option. The major ablative limbic system procedures currently used are anterior capsulotomy, dorsal anterior cingulotomy, subcaudate tractotomy, and limbic leucotomy. In this review, we include a brief history of ablative limbic system surgery leading up to its current form. Mechanistic justification for these procedures is considered in a discussion of the pathophysiology of psychiatric disease. We then discuss therapeutic efficacy as demonstrated by recent trials. Finally, we consider future directions, including the search for predictors of treatment response, the development of more precise targeting methods, and the use of advances in neuroimaging to track treatment response.
Literatur
1.
Catani M, Dell’acqua F, Thiebaut de Schotten M. A revised limbic system model for memory, emotion and behaviour. Neurosci Biobehav Rev. 2013;37(8):1724–37.CrossRefPubMed
2.
Papez JW. A proposed mechanism of emotion. 1937. J Neuropsychiatry Clin Neurosci. 1995;7(1):103–12.CrossRefPubMed
3.
Maclean PD. Some psychiatric implications of physiological studies on frontotemporal portion of limbic system (visceral brain). Electroencephalogr Clin Neurophysiol. 1952;4(4):407–18.CrossRefPubMed
4.
Saxena S, Rauch SL. Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin North Am. 2000;23(3):563–86.CrossRefPubMed
5.
Sackeim HA. The definition and meaning of treatment-resistant depression. J Clin Psychiatry. 2001;62 Suppl 16:10–7.PubMed
6.
Pallanti S, Quercioli L. Treatment-refractory obsessive-compulsive disorder: methodological issues, operational definitions and therapeutic lines. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(3):400–12.CrossRefPubMed
7.
Berlim MT, Turecki G. Definition, assessment, and staging of treatment-resistant refractory major depression: a review of current concepts and methods. Can J Psychiatry Rev Can Psychiatr. 2007;52(1):46–54.
8.
Luigjes J, de Kwaasteniet BP, de Koning PP, Oudijn MS, van den Munckhof P, Schuurman PR, et al. Surgery for psychiatric disorders. World Neurosurg. 2013;80(3–4):S31.e17–28.
9.
Mashour GA, Walker EE, Martuza RL. Psychosurgery: past, present, and future. Brain Res Brain Res Rev. 2005;48(3):409–19.CrossRefPubMed
10.
Raju TN. The Nobel chronicles. 1949: Walter Rudolf Hess (1881–1973); and Antônio Egas Moniz (1874–1955). Lancet. 1999;353(9160):1281.CrossRefPubMed
11.
El-Hai J. The lobotomist: a maverick medical genius and his tragic quest to rid the world of mental illness. Hoboken: Wiley; 2007. 368 p.
12.
Yang JC, Ginat DT, Dougherty DD, Makris N, Eskandar EN. Lesion analysis for cingulotomy and limbic leucotomy: comparison and correlation with clinical outcomes. J Neurosurg. 2014;120(1):152–63.CrossRefPubMedCentralPubMed
13.
Schoene-Bake J-C, Parpaley Y, Weber B, Panksepp J, Hurwitz TA, Coenen VA. Tractographic analysis of historical lesion surgery for depression. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 2010;35(13):2553–63.CrossRef
14.
Shields DC, Asaad W, Eskandar EN, Jain FA, Cosgrove GR, Flaherty AW, et al. Prospective assessment of stereotactic ablative surgery for intractable major depression. Biol Psychiatry. 2008;64(6):449–54.CrossRefPubMed
15.•
Lapidus KAB, Kopell BH, Ben-Haim S, Rezai AR, Goodman WK. History of psychosurgery: a psychiatrist’s perspective. World Neurosurg. 2013;80(3–4):S27.e1–16. This is an accessible review of psychiatric neurosurgery from the perspective of psychiatry that discusses its history with an overview of each procedure.
16.
Pereira EAC, Green AL, Nandi D, Aziz TZ. Stereotactic neurosurgery in the United Kingdom: the hundred years from Horsley to Hariz. Neurosurgery. 2008;63(3):594–606. discussion 606–7.CrossRefPubMed
17.
Spiegel EA, Wycis HT, Marks M, Lee AJ. Stereotaxic apparatus for operations on the human brain. Science. 1947;106(2754):349–50.CrossRefPubMed
18.
Alexander GE, Crutcher MD. Functional architecture of basal ganglia circuits: neural substrates of parallel processing. Trends Neurosci. 1990;13(7):266–71.CrossRefPubMed
19.
Posner J, Marsh R, Maia TV, Peterson BS, Gruber A, Simpson HB. Reduced functional connectivity within the limbic cortico-striato-thalamo-cortical loop in unmedicated adults with obsessive-compulsive disorder. Hum Brain Mapp. 2014;35(6):2852–60.CrossRefPubMedCentralPubMed
20.
Alexander GE, DeLong MR, Strick PL. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci. 1986;9:357–81.CrossRefPubMed
21.
Menzies L, Chamberlain SR, Laird AR, Thelen SM, Sahakian BJ, Bullmore ET. Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. Neurosci Biobehav Rev. 2008;32(3):525–49.CrossRefPubMedCentralPubMed
22.
Göttlich M, Krämer UM, Kordon A, Hohagen F, Zurowski B. Decreased limbic and increased fronto-parietal connectivity in unmedicated patients with obsessive-compulsive disorder. Hum Brain Mapp. 2014;35(11):5617–32.CrossRefPubMed
23.
Marchand WR. Cortico-basal ganglia circuitry: a review of key research and implications for functional connectivity studies of mood and anxiety disorders. Brain Struct Funct. 2010;215(2):73–96.CrossRefPubMed
24.
25.
Swedo SE, Schapiro MB, Grady CL, Cheslow DL, Leonard HL, Kumar A, et al. Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder. Arch Gen Psychiatry. 1989;46(6):518–23.CrossRefPubMed
26.
Saxena S, Brody AL, Ho ML, Zohrabi N, Maidment KM, Baxter LR. Differential brain metabolic predictors of response to paroxetine in obsessive-compulsive disorder versus major depression. Am J Psychiatry. 2003;160(3):522–32.CrossRefPubMed
27.
Nakao T, Okada K, Kanba S. Neurobiological model of obsessive-compulsive disorder: evidence from recent neuropsychological and neuroimaging findings. Psychiatry Clin Neurosci. 2014;68(8):587–605.CrossRefPubMed
28.
Baxter LR, Phelps ME, Mazziotta JC, Guze BH, Schwartz JM, Selin CE. Local cerebral glucose metabolic rates in obsessive-compulsive disorder. A comparison with rates in unipolar depression and in normal controls. Arch Gen Psychiatry. 1987;44(3):211–8.CrossRefPubMed
29.
Breiter HC, Rauch SL, Kwong KK, et al. Functional magnetic resonance imaging of symptom provocation in obsessive-compulsive disorder. Arch Gen Psychiatry. 1996;53(7):595–606.CrossRefPubMed
30.
Adler CM, McDonough-Ryan P, Sax KW, Holland SK, Arndt S, Strakowski SM. fMRI of neuronal activation with symptom provocation in unmedicated patients with obsessive compulsive disorder. J Psychiatr Res. 2000;34(4–5):317–24.CrossRefPubMed
31.
Hou J-M, Zhao M, Zhang W, Song L-H, Wu W-J, Wang J, et al. Resting-state functional connectivity abnormalities in patients with obsessive-compulsive disorder and their healthy first-degree relatives. J Psychiatry Neurosci JPN. 2014;39(5):304–11.CrossRef
32.
Milad MR, Rauch SL. Obsessive-compulsive disorder: beyond segregated cortico-striatal pathways. Trends Cogn Sci. 2012;16(1):43–51.CrossRefPubMed
33.
Kopell BH, Greenberg B, Rezai AR. Deep brain stimulation for psychiatric disorders. J Clin Neurophysiol Off Publ Am Electroencephalogr Soc. 2004;21(1):51–67.
34.
Leksell L, Backlund EO. Radiosurgical capsulotomy—a closed surgical method for psychiatric surgery. Lakartidningen. 1978;75(7):546–7.PubMed
35.
Lévêque M, Carron R, Régis J. Radiosurgery for the treatment of psychiatric disorders: a review. World Neurosurg. 2013;80(3–4):S32.e1–9.
36.•
Lopes AC, Greenberg BD, Canteras MM, Batistuzzo MC, Hoexter MQ, Gentil AF, et al. Gamma ventral capsulotomy for obsessive-compulsive disorder: a randomized clinical trial. JAMA Psychiatry. 2014;71(9):1066–76. This is the first randomized controlled trial of an ablative limbic system surgery (Gamma capsulotomy), and features thorough explanations of patient selection post-operative clinical course. CrossRefPubMed
37.
Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–11.CrossRefPubMed
38.
D’Astous M, Cottin S, Roy M, Picard C, Cantin L. Bilateral stereotactic anterior capsulotomy for obsessive-compulsive disorder: long-term follow-up. J Neurol Neurosurg Psychiatry. 2013;84(11):1208–13.CrossRefPubMed
39.
Oliver B, Gascón J, Aparicio A, Ayats E, Rodriguez R, Maestro De León JL, et al. Bilateral anterior capsulotomy for refractory obsessive-compulsive disorders. Stereotact Funct Neurosurg. 2003;81(1–4):90–5.CrossRefPubMed
40.
Rück C, Andréewitch S, Flyckt K, Edman G, Nyman H, Meyerson BA, et al. Capsulotomy for refractory anxiety disorders: long-term follow-up of 26 patients. Am J Psychiatry. 2003;160(3):513–21.CrossRefPubMed
41.
Liu K, Zhang H, Liu C, Guan Y, Lang L, Cheng Y, et al. Stereotactic treatment of refractory obsessive compulsive disorder by bilateral capsulotomy with 3 years follow-up. J Clin Neurosci Off J Neurosurg Soc Australas. 2008;15(6):622–9.
42.
Zhan S, Liu W, Li D, Pan S, Pan Y, Li Y, et al. Long-term follow-up of bilateral anterior capsulotomy in patients with refractory obsessive-compulsive disorder. Clin Neurol Neurosurg. 2014;119:91–5.CrossRefPubMed
43.
Christmas D, Eljamel MS, Butler S, Hazari H, MacVicar R, Steele JD, et al. Long term outcome of thermal anterior capsulotomy for chronic, treatment refractory depression. J Neurol Neurosurg Psychiatry. 2011;82(6):594–600.CrossRefPubMed
44.
Hurwitz TA, Honey CR, Allen J, Gosselin C, Hewko R, Martzke J, et al. Bilateral anterior capsulotomy for intractable depression. J Neuropsychiatry Clin Neurosci. 2012;24(2):176–82.
45.
Rück C, Karlsson A, Steele JD, Edman G, Meyerson BA, Ericson K, et al. Capsulotomy for obsessive-compulsive disorder: long-term follow-up of 25 patients. Arch Gen Psychiatry. 2008;65(8):914–21.
46.
Lopes AC, Greenberg BD, Norén G, Canteras MM, Busatto GF, de Mathis ME, et al. Treatment of resistant obsessive-compulsive disorder with ventral capsular/ventral striatal gamma capsulotomy: a pilot prospective study. J Neuropsychiatry Clin Neurosci. 2009;21(4):381–92.
47.
Mindus P, Jenike MA. Neurosurgical treatment of malignant obsessive compulsive disorder. Psychiatr Clin North Am. 1992;15(4):921–38.
48.
Kondziolka D, Flickinger JC, Hudak R. Results following gamma knife radiosurgical anterior capsulotomies for obsessive compulsive disorder. Neurosurgery. 2011;68(1):28–32. discussion 23–3.CrossRefPubMed
49.
Loeffler JS, Niemierko A, Chapman PH. Second tumors after radiosurgery: tip of the iceberg or a bump in the road? Neurosurgery. 2003;52(6):1436–40. discussion 1440–2.CrossRefPubMed
50.
Suetens K, Nuttin B, Gabriëls L, Van Laere K. Differences in metabolic network modulation between capsulotomy and deep-brain stimulation for refractory obsessive-compulsive disorder. J Nucl Med Off Publ Soc Nucl Med. 2014;55(6):951–9.
51.
Zuo C, Ma Y, Sun B, Peng S, Zhang H, Eidelberg D, et al. Metabolic imaging of bilateral anterior capsulotomy in refractory obsessive compulsive disorder: an FDG PET study. J Cereb Blood Flow Metab Off J Int Soc Cereb Blood Flow Metab. 2013;33(6):880–7.CrossRef
52.
Taren JA, Curtis GC, Gebarski SS. Late local and remote structural changes after capsulotomy for obsessive compulsive disorder. Stereotact Funct Neurosurg. 1994;63(1–4):1–6.CrossRefPubMed
53.
Hurwitz TA, Mandat T, Forster B, Honey C. Tract identification by novel MRI signal changes following stereotactic anterior capsulotomy. Stereotact Funct Neurosurg. 2006;84(5–6):228–35.CrossRefPubMed
54.
Sheehan JP, Patterson G, Schlesinger D, Xu Z. γ knife surgery anterior capsulotomy for severe and refractory obsessive-compulsive disorder. J Neurosurg. 2013;119(5):1112–8.CrossRefPubMed
55.
Martin E, Jeanmonod D, Morel A, Zadicario E, Werner B. High-intensity focused ultrasound for noninvasive functional neurosurgery. Ann Neurol. 2009;66(6):858–61.CrossRefPubMed
56.
Jeanmonod D, Werner B, Morel A, Michels L, Zadicario E, Schiff G, et al. Transcranial magnetic resonance imaging-guided focused ultrasound: noninvasive central lateral thalamotomy for chronic neuropathic pain. Neurosurg Focus. 2012;32(1):E1.CrossRefPubMed
57.
Jung HH, Chang WS, Rachmilevitch I, Tlusty T, Zadicario E, Chang JW. Different magnetic resonance imaging patterns after transcranial magnetic resonance-guided focused ultrasound of the ventral intermediate nucleus of the thalamus and anterior limb of the internal capsule in patients with essential tremor or obsessive-compulsive disorder. J Neurosurg. 2015;122(1):162–8.
58.
Ballantine HT, Bouckoms AJ, Thomas EK, Giriunas IE. Treatment of psychiatric illness by stereotactic cingulotomy. Biol Psychiatry. 1987;22(7):807–19.CrossRefPubMed
59.
Gasquoine PG. Localization of function in anterior cingulate cortex: from psychosurgery to functional neuroimaging. Neurosci Biobehav Rev. 2013;37(3):340–8.CrossRefPubMed
60.
Sheth SA, Mian MK, Patel SR, Asaad WF, Williams ZM, Dougherty DD, et al. Human dorsal anterior cingulate cortex neurons mediate ongoing behavioural adaptation. Nature. 2012;488(7410):218–21.CrossRefPubMedCentralPubMed
61.
Shenhav A, Botvinick MM, Cohen JD. The expected value of control: an integrative theory of anterior cingulate cortex function. Neuron. 2013;79(2):217–40.CrossRefPubMedCentralPubMed
62.
Rainville P, Duncan GH, Price DD, Carrier B, Bushnell MC. Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science. 1997;277(5328):968–71.CrossRefPubMed
63.
Emmert K, Breimhorst M, Bauermann T, Birklein F, Van De Ville D, Haller S. Comparison of anterior cingulate vs. insular cortex as targets for real-time fMRI regulation during pain stimulation. Front Behav Neurosci. 2014;8:350.CrossRefPubMedCentralPubMed
64.
Morita T, Tanabe HC, Sasaki AT, Shimada K, Kakigi R, Sadato N. The anterior insular and anterior cingulate cortices in emotional processing for self-face recognition. Soc Cogn Affect Neurosci. 2014;9(5):570–9.CrossRefPubMedCentralPubMed
65.
Shackman AJ, Salomons TV, Slagter HA, Fox AS, Winter JJ, Davidson RJ. The integration of negative affect, pain and cognitive control in the cingulate cortex. Nat Rev Neurosci. 2011;12(3):154–67.CrossRefPubMedCentralPubMed
66.•
Sheth SA, Neal J, Tangherlini F, Mian MK, Gentil A, Cosgrove GR, et al. Limbic system surgery for treatment-refractory obsessive-compulsive disorder: a prospective long-term follow-up of 64 patients. J Neurosurg. 2013;118(3):491–7. This prospective study features the largest sample size of patients treated with dorsal anterior cingulotomy. It follows up and adds patients to previous similar studies, demonstrating the long-term therapeutic course of limbic system surgeries. CrossRefPubMed
67.
Jung HH, Kim C-H, Chang JH, Park YG, Chung SS, Chang JW. Bilateral anterior cingulotomy for refractory obsessive-compulsive disorder: long-term follow-up results. Stereotact Funct Neurosurg. 2006;84(4):184–9.CrossRefPubMed
68.
Kim C-H, Chang JW, Koo M-S, Kim JW, Suh HS, Park IH, et al. Anterior cingulotomy for refractory obsessive-compulsive disorder. Acta Psychiatr Scand. 2003;107(4):283–90.CrossRefPubMed
69.
Zhang QJ, Wang WH, Wei XP. Long-term efficacy of stereotactic bilateral anterior cingulotomy and bilateral anterior capsulotomy as a treatment for refractory obsessive-compulsive disorder. Stereotact Funct Neurosurg. 2013;91(4):258–61.CrossRefPubMed
70.
Dougherty DD, Baer L, Cosgrove GR, Cassem EH, Price BH, Nierenberg AA, et al. Prospective long-term follow-up of 44 patients who received cingulotomy for treatment-refractory obsessive-compulsive disorder. Am J Psychiatry. 2002;159(2):269–75.CrossRefPubMed
71.
Baer L, Rauch SL, Ballantine HT, Martuza R, Cosgrove R, Cassem E, et al. Cingulotomy for intractable obsessive-compulsive disorder. Prospective long-term follow-up of 18 patients. Arch Gen Psychiatry. 1995;52(5):384–92.CrossRefPubMed
72.
Bush G, Shin LM, Holmes J, Rosen BR, Vogt BA. The Multi-Source Interference Task: validation study with fMRI in individual subjects. Mol Psychiatry. 2003;8(1):60–70.CrossRefPubMed
73.
Janer KW, Pardo JV. Deficits in selective attention following bilateral anterior cingulotomy. J Cogn Neurosci. 1991;3(3):231–41.CrossRefPubMed
74.
Banks GP, Mikell CB, Youngerman BE, Henriques B, Kelly KM, Chan AK, et al. Neuroanatomical characteristics associated with response to dorsal anterior cingulotomy for obsessive-compulsive disorder. JAMA Psychiatry. 2014;72(2):127–35.CrossRef
75.
76.
Kartsounis LD, Poynton A, Bridges PK, Bartlett JR. Neuropsychological correlates of stereotactic subcaudate tractotomy. A prospective study. Brain J Neurol. 1991;114(Pt 6):2657–73.CrossRef
77.
Lehman JF, Greenberg BD, McIntyre CC, Rasmussen SA, Haber SN. Rules ventral prefrontal cortical axons use to reach their targets: implications for diffusion tensor imaging tractography and deep brain stimulation for psychiatric illness. J Neurosci Off J Soc Neurosci. 2011;31(28):10392–402.CrossRef
78.
Jbabdi S, Lehman JF, Haber SN, Behrens TE. Human and monkey ventral prefrontal fibers use the same organizational principles to reach their targets: tracing versus tractography. J Neurosci Off J Soc Neurosci. 2013;33(7):3190–201.CrossRef
79.
Kelly D, Richardson A, Mitchell-Heggs N, Greenup J, Chen C, Hafner RJ. Stereotactic limbic leucotomy: a preliminary report on forty patients. Br J Psychiatry J Ment Sci. 1973;123(573):141–8.CrossRef
80.
Cho D-Y, Lee W-Y, Chen C-C. Limbic leukotomy for intractable major affective disorders: a 7-year follow-up study using nine comprehensive psychiatric test evaluations. J Clin Neurosci Off J Neurosurg Soc Australas. 2008;15(2):138–42.
81.
Bourne SK, Sheth SA, Neal J, Strong C, Mian MK, Cosgrove GR, et al. Beneficial effect of subsequent lesion procedures after nonresponse to initial cingulotomy for severe, treatment-refractory obsessive-compulsive disorder. Neurosurgery. 2013;72(2):196–202. discussion 202.CrossRefPubMed
82.
Rauch SL, Dougherty DD, Cosgrove GR, Cassem EH, Alpert NM, Price BH, et al. Cerebral metabolic correlates as potential predictors of response to anterior cingulotomy for obsessive compulsive disorder. Biol Psychiatry. 2001;50(9):659–67.CrossRefPubMed
83.
Dougherty DD, Weiss AP, Cosgrove GR, Alpert NM, Cassem EH, Nierenberg AA, et al. Cerebral metabolic correlates as potential predictors of response to anterior cingulotomy for treatment of major depression. J Neurosurg. 2003;99(6):1010–7.CrossRefPubMed
Metadaten
Titel
Ablative Limbic System Surgery: Review and Future Directions
verfasst von
Saurabh Sinha
Robert A. McGovern
Charles B. Mikell
Garrett P. Banks
Sameer A. Sheth
Publikationsdatum
01.06.2015
Verlag
Springer International Publishing
Erschienen in
Current Behavioral Neuroscience Reports / Ausgabe 2/2015
Elektronische ISSN: 2196-2979
DOI
https://doi.org/10.1007/s40473-015-0038-1

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