Bilateral Cingulotomy - Case Studies

Case Studies

A recent study conducted at the Massachusetts General Hospital analyzed the outcome of bilateral cingulotomy in 44 patients for the treatment of OCD in the period between 1965 and 1986. Patients were followed up over a long term and evaluated based on several criteria: 1) how many of them were responders after a period of 6 months, 2) how many cingulotomies had a patient undergone before the examination of the effectiveness of the procedure, 3) did the patient show any significant change after the most recent procedure and 4) what were the side effects related to the procedure.

The follow up of the patients produced contradictory results, which indicated that bilateral cingulotomy is not the optimal treatment for OCD as of today. From the 44 patients only 32% could be classified as responders and showed significant improvement compared to the other subjects. Another 14% exhibited some signs of improvement. Multiple cingultomies lead to the increase in responders by 6% and to partial responders by 11%. However, the side effects associated with the procedure were numerous. Among the complaints that patients had after the surgery were deficits in memory and apathy although these were rarely observed. In addition, some of the subjects complained from some form of urinary disturbance ranging from urinary retention to incontinence. Hydrocephalus (2%) and seizures (2%) were also observed .

Another clinical study investigated the effect of bilateral cingulotomy for the treatment of refractory chronic pain. In this case 23 patients that were subject to 28 cingulotomies in total were followed up. The analyses aimed at determining how much the pain of each individual was affected after the procedure with the help of a questionnaire. In addition, the examiners tried to evaluate the social and family relations of the participants in the study. Based on the data obtained, cingulatomy for treatment of chronic pain showed promising results. 72% reported improvement in the level of pain experienced, and 50% indicated that they no longer required painkillers after cingulotomy. More than half of the patients also claimed that the surgical procedure was beneficial and contributed to the improvement of their social aspects.

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