Magnetic resonance image-guided stereotactic cingulotomy for intractable psychiatric disease
Abstract
We describe the modern operative technique of magnetic resonance (MR) image-guided stereotactic cingulotomy and discuss the indications, results, and complications of this procedure. A retrospective analysis of psychiatric outcome was performed for 34 patients with intractable major affective disorder and/or obsessive-compulsive disorder who underwent MR image-guided stereotactic cingulotomy since 1991. Fourteen patients underwent multiple cingulotomies (50 total procedures). Overall, 38% of the patients were classified as responders, 23% as possible responders, and 38% as nonresponders. Of the patients who did not respond to initial cingulotomies and who underwent multiple cingulotomies, 36% became responders, 36% possible responders, and 28% nonresponders. There were no deaths or long-term side effects related to the procedure. The therapeutic results of MR image-guided stereotactic cingulotomy are similar to the results of earlier methods of cingulotomy, and the use of MR imaging offers substantial technical advantages. This procedure also compares favorably with other neurosurgical procedures performed for intractable psychiatric disease with a low rate of undesired side effects. Cingulotomy is safe and well tolerated, with over one-third of the patients demonstrating significant improvement; however, prospective long-term follow-up studies are needed to further define the role of surgery in treating intractable psychiatric disease.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Anterior cingulotomies compromise the cingulum but cause additional cortical damage, principally in area 24.
“The advent of computerised tomography and subsequent MR imaging, confirmed that although anterior cingulotomies do compromise the cingulum (Steele et al., 2008; Turner., 1973), they cause additional cortical damage, principally in area 24 (Spangler et al., 1996; Steele et al., 2008).”
From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Spangler et al., 1996
Cites
Stereotaxic anterior cingulotomy for neuropsychiatric illness and intractable pain
Ballantine, H. T., Cassidy, W. L., Flanagan, N. B., & Marino, R. (1967) · Journal of Neurosurgery · doi:10.3171/jns.1967.26.5.0488 · Cited by 370 · see citing works
Self-citationTreatment of psychiatric illness by stereotactic cingulotomy
Ballantine, H. T., Bouckoms, A. J., Thomas, E. K., & Giriunas, I. E. (1987) · Biological Psychiatry · doi:10.1016/0006-3223(87)90080-1 · Cited by 328 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Schmahmann, J. D., Pandya, D. N., Wang, R., Dai, G., D'Arceuil, H. E., de Crespigny, A. J., & Wedeen, V. J. (2007) · Brain · doi:10.1093/brain/awl359 · Cited by 1,067 · see citing works
Voxel-wise meta-analysis of grey matter changes in obsessive-compulsive disorder
Radua, J., & Mataix-Cols, D. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.108.055046 · Cited by 863 · see citing works
The cingulum bundle: Anatomy, function, and dysfunction
Bubb, E. J., Metzler-Baddeley, C., & Aggleton, J. P. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.05.008 · Cited by 740 · see citing works
The neuropsychiatry of the cerebellum — insights from the clinic
Schmahmann, J. D., Weilburg, J. B., & Sherman, J. C. (2007) · The Cerebellum · doi:10.1080/14734220701490995 · Cited by 718 · see citing works
Neural Responses to Monetary Incentives in Major Depression
Knutson, B., Bhanji, J. P., Cooney, R. E., Atlas, L. Y., & Gotlib, I. H. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.07.023 · Cited by 496 · see citing works
Dougherty, D. D., Weiss, A. P., Cosgrove, G. R., Alpert, N. M., Cassem, E. H., Nierenberg, A. A., Price, B. H., Mayberg, H. S., Fischman, A. J., & Rauch, S. L. (2003) · Journal of Neurosurgery · doi:10.3171/jns.2003.99.6.1010 · Cited by 193 · see citing works
Self-citationGamma Ventral Capsulotomy for Obsessive-Compulsive Disorder: A Randomized Clinical Trial
Lopes, A. C., Greenberg, B. D., Canteras, M. M., Batistuzzo, M. C., Hoexter, M. Q., Gentil, A. F., Pereira, C. A. B., Joaquim, M. A., de Mathis, M. E., D’Alcante, C. C., et al. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.1193 · Cited by 161 · see citing works
Rauch, S. L., Dougherty, D. D., Cosgrove, G. R., Cassem, E. H., Alpert, N. M., Price, B. H., Nierenberg, A. A., Mayberg, H. S., Baer, L., Jenike, M. A., et al. (2001) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01188-x · Cited by 150 · see citing works
Self-citationRichter, E. O., Davis, K. D., Hamani, C., Hutchison, W. D., Dostrovsky, J. O., & Lozano, A. M. (2004) · Neurosurgery · doi:10.1227/01.neu.0000108644.42992.95 · Cited by 69 · see citing works
- Authors
- Spangler, W. J., Cosgrove, G. R., Ballantine, H. T., Cassem, E. H., Rauch, S. L., Nierenberg, A., & Price, B. H.
- Affiliations
- Harvard University (US)
- Venue
- Neurosurgery
- Published
- 1996-06
- Volume
- 38
- Issue
- 6
- Pages
- 1071-1078
- ISSN
- 0148-396X (ISSN-L)
- OpenAlex
- W4233593702
- Cited by
- 130
- References
- 2
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2022: 3 · 2021: 3 · 2020: 1 · 2018: 7 · 2016: 3 · 2015: 6 · 2014: 9 · 2013: 7 · 2012: 9
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- PubMed
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- major affective disorders, obsessive-compulsive disorder, procedural safety, treatment response
- MeSH terms
- Adolescent, Adult, Aged, Bipolar Disorder, Brain Mapping, Depressive Disorder, Female, Follow-Up Studies, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Obsessive-Compulsive Disorder, Reoperation, Stereotaxic Techniques, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
