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Cited by 69Neurological disorders and treatmentsObsessive-Compulsive Spectrum DisordersElectroconvulsive Therapy Studies

Cingulotomy for psychiatric disease: microelectrode guidance, a callosal reference system for documenting lesion location, and clinical results

Richter, Erich O., Davis, Karen D., Hamani, Clement, Hutchison, William D., Dostrovsky, Jonathan O., Lozano, Andres M.·2004·Neurosurgery
DOI 10.1227/01.neu.0000108644.42992.95
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Abstract

Objective To evaluate magnetic resonance imaging (MRI)- and microelectrode recording-guided cingulotomy for patients with psychiatric disorders and to develop a new method of mapping lesion location in anterior cingulate cortex that takes into account the significant interindividual variability in callosal morphometry. Methods MRI and microelectrode recording were used to guide placement of radiofrequency lesions in patients with obsessive-compulsive disorder (n = 21) or affective disorders (n = 5). Postoperative improvement was evaluated with the Yale-Brown Obsessive-Compulsive Scale in 15 of the 21 obsessive-compulsive disorder patients studied. From the postoperative MRI scans, we developed a coordinate system for position in the anterior cingulate cortex. The callosal line passes from the most anterior point of the corpus callosum (c = 0) to the most posterior (c = 100). We reconstructed the lesions onto a sagittal map from the Talairach and Tournoux atlas using the distance along the callosal line and the distance above the upper surface of the corpus callosum. Results The location of neuronal activity distinguished gray and white matter and was useful in delineating the upper and lower cortical banks of the cingulate gyrus, the cingulate bundle, and the corpus callosum. This information was used to place the lesions. Lesions typically were 6 to 8 mm in diameter on T2-weighted MRI scans. The inferior margins were along the corpus callosum from c = 16 to c = 38. Four of 1…

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  • Lesions placed a little behind the genu were associated with better outcomes than those more caudal, at mid cingulate levels.

    “This same study of 8 cases found that lesions placed a little behind the genu were associated with better outcomes than those more caudal, at mid cingulate levels (Steele et al., 2008; see also Corkin, 1980; Richter et al., 2004).”

    From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Richter et al., 2004

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Authors
Richter, E. O., Davis, K. D., Hamani, C., Hutchison, W. D., Dostrovsky, J. O., & Lozano, A. M.
Affiliations
University of Toronto (CA)
ORCID
Venue
Neurosurgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-03
Volume
54
Issue
3
Pages
622-630
ISSN
0148-396X (ISSN-L)
DOI
10.1227/01.neu.0000108644.42992.95
OpenAlex
W1964773953
Cited by
69
References
49
Citations by year
2026: 1 · 2025: 1 · 2023: 4 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 4 · 2016: 3 · 2015: 4 · 2014: 7 · 2013: 10 · 2012: 2
FWCI
2.01
Type
journal article
Language
en
Open access
closed
Locations
  • Neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Yale University
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
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
cingulotomy, anterior cingulate cortex, obsessive-compulsive disorder, mood disorders, microelectrode recording, corpus callosum, radiofrequency lesioning, cingulate gyrus, Yale-Brown Obsessive Compulsive Scale
MeSH terms
Adult, Aged, Major Depressive Disorder, Electroencephalography, Female, Follow-Up Studies, Gyrus Cinguli, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Microelectrodes, Middle Aged, Obsessive-Compulsive Disorder, Personality Assessment, Postoperative Complications, Psychotic Disorders, Reoperation, Treatment Outcome, Surgery, Computer-Assisted

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