Network analysis in Gamma Knife capsulotomy for intractable obsessive-compulsive disorder

Tim A M Bouwens van der Vlis; Yavuz Samanci; Linda Ackermans; Koen R J Schruers; Y Temel; Albert F G Leentjens; Alp Dincer; Selçuk Peker

doi:10.1016/j.bas.2022.100892

Network analysis in Gamma Knife capsulotomy for intractable obsessive-compulsive disorder

Tim A M Bouwens van der Vlis^*, Yavuz Samanci, Linda Ackermans, Koen R J Schruers, Y Temel, Albert F G Leentjens, Alp Dincer, Selçuk Peker

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Introduction: Gamma-knife Ventral Capsulotomy (GVC) has been suggested as an efficacious treatment for a subset of patients with treatment refractory obsessive compulsive disorder (OCD).

Research question: The goal of this study was to investigate neural correlates of GVC and investigate the predictive value of white matter tracts that are known to be associated with clinical outcome to Deep Brain Stimulation (DBS).

Material and methods: MR images of 8 treatment-refractory OCD patients with a minimum follow-up of 3-years who underwent GVC were used to correlate lesion characteristics with symptom improvement. This exploratory study investigated relations between differences in cortical grey matter structure and subcortical structures before and after GVC for responding and non-responding patients (n = 6). Normative diffusion MRI- based tractography was used to determine networks associated with successful lesions.

Results: The mean total Y-BOCS reduction was 19.6 after three years, resulting in a response rate of 63%.The strongest correlation with symptom improvement was found for a decrease of the left ventral diencephalon volume (r = -0.83, p = 0.039). Discriminative tractography suggest streamlines connecting the prefrontal cortex with the subthalamic nucleus to be associated with clinical response. However, results could not be validated either implicating interpatient anatomical variability or reflecting the relative small sample size as a limitation.

Discussion/Conclusion: Taken together, the present study highlights the efficacy of GVC in patients with treatment-refractory OCD. Our results are suggestive of GVC treatment efficacy being mediated by the involvement of a subpart of the ALIC connecting the PFC and the STN.

Original language	English
Article number	100892
Number of pages	6
Journal	Brain and Spine
Volume	2
DOIs	https://doi.org/10.1016/j.bas.2022.100892
Publication status	Published - 2022

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Cite this

@article{ebbf9737a3ec41dabc600b7a7d42ff9f,

title = "Network analysis in Gamma Knife capsulotomy for intractable obsessive-compulsive disorder",

abstract = "Introduction: Gamma-knife Ventral Capsulotomy (GVC) has been suggested as an efficacious treatment for a subset of patients with treatment refractory obsessive compulsive disorder (OCD).Research question: The goal of this study was to investigate neural correlates of GVC and investigate the predictive value of white matter tracts that are known to be associated with clinical outcome to Deep Brain Stimulation (DBS).Material and methods: MR images of 8 treatment-refractory OCD patients with a minimum follow-up of 3-years who underwent GVC were used to correlate lesion characteristics with symptom improvement. This exploratory study investigated relations between differences in cortical grey matter structure and subcortical structures before and after GVC for responding and non-responding patients (n = 6). Normative diffusion MRI- based tractography was used to determine networks associated with successful lesions.Results: The mean total Y-BOCS reduction was 19.6 after three years, resulting in a response rate of 63%.The strongest correlation with symptom improvement was found for a decrease of the left ventral diencephalon volume (r = -0.83, p = 0.039). Discriminative tractography suggest streamlines connecting the prefrontal cortex with the subthalamic nucleus to be associated with clinical response. However, results could not be validated either implicating interpatient anatomical variability or reflecting the relative small sample size as a limitation.Discussion/Conclusion: Taken together, the present study highlights the efficacy of GVC in patients with treatment-refractory OCD. Our results are suggestive of GVC treatment efficacy being mediated by the involvement of a subpart of the ALIC connecting the PFC and the STN.",

author = "{Bouwens van der Vlis}, {Tim A M} and Yavuz Samanci and Linda Ackermans and Schruers, {Koen R J} and Y Temel and Leentjens, {Albert F G} and Alp Dincer and Sel{\c c}uk Peker",

note = "{\textcopyright} 2022 The Authors.",

year = "2022",

doi = "10.1016/j.bas.2022.100892",

language = "English",

volume = "2",

journal = "Brain and Spine",

issn = "2772-5294",

publisher = "Elsevier",

}

TY - JOUR

T1 - Network analysis in Gamma Knife capsulotomy for intractable obsessive-compulsive disorder

AU - Bouwens van der Vlis, Tim A M

AU - Samanci, Yavuz

AU - Ackermans, Linda

AU - Schruers, Koen R J

AU - Temel, Y

AU - Leentjens, Albert F G

AU - Dincer, Alp

AU - Peker, Selçuk

PY - 2022

Y1 - 2022

N2 - Introduction: Gamma-knife Ventral Capsulotomy (GVC) has been suggested as an efficacious treatment for a subset of patients with treatment refractory obsessive compulsive disorder (OCD).Research question: The goal of this study was to investigate neural correlates of GVC and investigate the predictive value of white matter tracts that are known to be associated with clinical outcome to Deep Brain Stimulation (DBS).Material and methods: MR images of 8 treatment-refractory OCD patients with a minimum follow-up of 3-years who underwent GVC were used to correlate lesion characteristics with symptom improvement. This exploratory study investigated relations between differences in cortical grey matter structure and subcortical structures before and after GVC for responding and non-responding patients (n = 6). Normative diffusion MRI- based tractography was used to determine networks associated with successful lesions.Results: The mean total Y-BOCS reduction was 19.6 after three years, resulting in a response rate of 63%.The strongest correlation with symptom improvement was found for a decrease of the left ventral diencephalon volume (r = -0.83, p = 0.039). Discriminative tractography suggest streamlines connecting the prefrontal cortex with the subthalamic nucleus to be associated with clinical response. However, results could not be validated either implicating interpatient anatomical variability or reflecting the relative small sample size as a limitation.Discussion/Conclusion: Taken together, the present study highlights the efficacy of GVC in patients with treatment-refractory OCD. Our results are suggestive of GVC treatment efficacy being mediated by the involvement of a subpart of the ALIC connecting the PFC and the STN.

AB - Introduction: Gamma-knife Ventral Capsulotomy (GVC) has been suggested as an efficacious treatment for a subset of patients with treatment refractory obsessive compulsive disorder (OCD).Research question: The goal of this study was to investigate neural correlates of GVC and investigate the predictive value of white matter tracts that are known to be associated with clinical outcome to Deep Brain Stimulation (DBS).Material and methods: MR images of 8 treatment-refractory OCD patients with a minimum follow-up of 3-years who underwent GVC were used to correlate lesion characteristics with symptom improvement. This exploratory study investigated relations between differences in cortical grey matter structure and subcortical structures before and after GVC for responding and non-responding patients (n = 6). Normative diffusion MRI- based tractography was used to determine networks associated with successful lesions.Results: The mean total Y-BOCS reduction was 19.6 after three years, resulting in a response rate of 63%.The strongest correlation with symptom improvement was found for a decrease of the left ventral diencephalon volume (r = -0.83, p = 0.039). Discriminative tractography suggest streamlines connecting the prefrontal cortex with the subthalamic nucleus to be associated with clinical response. However, results could not be validated either implicating interpatient anatomical variability or reflecting the relative small sample size as a limitation.Discussion/Conclusion: Taken together, the present study highlights the efficacy of GVC in patients with treatment-refractory OCD. Our results are suggestive of GVC treatment efficacy being mediated by the involvement of a subpart of the ALIC connecting the PFC and the STN.

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