Входя на эту страницу, Вы подтверждаете, что являетесь  медицинским работником.

Status message

Not the entire site translated, but only to "Magazine"

APPLICATION OF MODERN NEUROSURGERIC METHODS IN COMPLEX TREATMENT OF THERAPEUTIC RESISTENT MENTAL DISORDERS

V.K. Shamrey1, E.Y. Abritalin2, А.V. Korzenev 1

1Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia
2North-western State Medical University named after I.I.Mechnikov, Saint-Petersburg, Russia

SUMMARY:
The article presents a brief historical overview of the neurosurgical methods development in psychiatric practice. The article also presents considers modern methods of functional neurosurgery and the results of neurosurgical correction in the complex therapy of therapeutic resistant mental disorders too. 32 patients with resistant obsessive-compulsive and depressive disorders have got neurosurgical treatment. According to CGI-I a significant improvement in mental state was noted in 26.0 % of cases, moderate –in 18.5 %, insignificant – in 44.5 %, lack of effect – in 11.0 % of observations; minor complications were observed in 15.6 % of operated patients.The using of functional stereotactic neurosurgery methods to overcome therapeutic resistance is safe and effective if the selection criteria and careful preoperative preparation, including the neuroimaging survey, will be met. But the authors specify that the using of neurosurgical correction in the mentally ill is possible only in absolutely non-incurable cases now.

References: 

1. Biologicheskiye metody terapii psikhicheskikh rasstroystv (dokazatel'naya meditsina – klinicheskoy praktike) / pod red. S.N. Mosolova. – M., 2012. – 1072 s..

2. Bykov Y.V., Bekker R.A., Reznikov M.K. Rezistentnyye depressii: prakticheskoye rukovodstvo. – Kiyev, 2013. – 400 s.

3. Mazo G.E., Neznanov N.G. Terapevticheski rezistentnyye depressii. – Sankt-Peterburg. – 2012. – 448 s.

4. Mosolov S.N., Alfimov P.V. Algoritm biologicheskoy terapii obsessivno-kompul'sivnogo rasstroystva // Sovremennaya terapiya psikhicheskikh rasstroystv. – 2013. – № 1. – S. 41-44.

5. Mosolov S.N. Rezistentnost' k psikhofarmakoterapii i metody yeye preodoleniya // Psikhiatriya i psikhofarmakoterapiya. – 2002. – T. 4, № 4. – S. 132-136.

6. Carvalho A.F., Mcintyre R.S. Treatment-Resistant Mood Disorders. – Oxford University Press, 2015. – 160 р.

7. Euba R., Panihhidina I., Zamar A. Treatment-resistant depression: the experience of the first rTMS Clinic in the UK // Future Neurology. – 2015. – Vol. 10, № 3. – P. 211–215.

8. Goltz F. Über die Verrichtungen des Großhirns. – Saarbrücken: VDM Verlag Dr. Müller, 2006. – 188 s.

9. Burckhardt G. Ueber Rindenexcisionen, als Beitrag zur operativen Therapie der Psychosen (About cortical excision, as a contribution to surgical treatment of psychosis) // Allgemeine Zeitschift für Psychiatrie. – 1891, № 47. – S. 463–548.

10. Bekhterev V.M., Pussep L.M. Khirurgiya pri dushevnykh boleznyakh. – Spb.: Tip. 1-y Trudovoy Arteli, 1908. – 51 c.

11. Fulton J.F., Dzhekobsen T.F. Funktsii lobnykh doley mozga: Sravnitel'noye issledovaniye nizshikh obez'yan, shimpanze i cheloveka // Fiziol. zhurn. SSSR. – 1935. – T.19, vyp.1. – S. 359-370.

12. Moniz E., Lima A. Symptomes du lobe prefrontal // Rev. neurol. – 1936. – T. 65. – P. 582-595.

13. Freeman W.J., Watts J.W. Psychosurgery in the treatment of mental disorders and intractable pain. – 2-d ed. – Springfield: C.C. Thomas, 1950. – 598 p.

14. Papez J.W. A proposed mechanism of emotion. 1937 // J. Neuropsychiatry Clin. Neurosci. – 1995. – Vol. 7, № 1. – P. 103-112.

15. Babchin I.S. Opyt khirurgicheskogo lecheniya nekotorykh form psikhicheskikh zabolevaniy // Vopr. neyrokhirurgii. – 1948. – T. 12, № 2. – C. 3-11.

16. Golant R.YA., Babchin I.S., Khvilivitskiy T.YA. i dr. Effektivnost' dvustoroney lobnoy leykotomii v lechenii shizofrenii i drugikh psikhicheskikh zabolevaniy // Tr. Vsesoyuznogo s"yezda nevropat. i psikhiatrov. – 1950. – S. 398-400.

17. Horsley V., Clarke R.H. The structure and functions of the cerebellum examined by a new method // Brain. – 1908. – Vol. 31. – P. 45-123.

18. Abrakov L.V. Osnovy stereotaksicheskoy neyrokhirurgii. – L.: Meditsina, 1975. – 232 s.

19. Hess W.R. Diencephalon: Autonomic and extrapyramidal functions. – N.Y.: Grune a. Stratton, 1954. – 79 p.

20. Spiegel E., Wycis H. Principles and applications of steroencephalotomy // J. Intern. Coll. Surg. – 1950. – Vol. 14. – P. 394-402.

21. Valenstein E.S. Great and desperate cures: The rise and decline of psychosurgery and other radical treatments for mental illness. – N.Y.: Basic books, 1986. – 338 p.

22. Ballantine H.T., Bouckoms A.J., Thomas E.K., Giriunas I.E. Treatment of psychiatric illness by stereotactic cingulotomy // Biol. Psychiatry. – 1987. – Vol. 22, № 7. – P.807-819.

23. Shustin V.A., Vovin R.Ya., Korzenev A.V. Khirurgicheskaya korrektsiya nekotorykh psikhopatologicheskikh rasstroystv. – SPb., 1997. – 123 s.

24. Anichkov A.D., Melyucheva L.A., Oblyapin A.V. i dr. Opyt khirurgicheskogo lecheniya sindroma Zhilya de la Turetta. // Zhurnal nevrologii i psikhiatrii imeni S.S. Korsa-kova. – 2006. – T.106, № 8. – S. 58-61.

25. Skoromets T.A., Anichkov A.D., Polyakov YU.I., Naryshkin A.G. Khirurgicheskiye me-tody lecheniya v psikhiatricheskoy praktike // Psikhiatriya: natsional'noye rukovodstvo / gl. red. Yu.A. Aleksandrovskiy, N.G. Neznanov. - 2-ye izd., pererab. i dop. - M., 2018. – S. 978-995.

26. Anichkov A.D., Tochilov V.A., Spirin A.L., Plotnikova I.V., Polyakov YU.I. Ste-reotaksicheskoye lecheniye medikamentozno rezistentnykh form obsessivno-kompul'sivnogo rasstroystva. Nablyudeniye iz praktiki // Profilakticheskaya i klinicheskaya meditsina. – 2012. – № 1 (42). S. 48-53.

27. Korzenev A.V., Gaydar B.V., Neznanov N.G. i dr. O vozmozhnosti preodoleniya tera-pevticheskoy rezistentnosti malokurabel'nykh trevozhno-obsessivnykh rasstroystv s ispol'zovaniyem metodov funktsional'noy stereotaksicheskoy neyrokhirurgii // Psikhiatriya. – 2004. – T. II, № 5. – C. 14-25.

28. Robison R.A., Taghva A. Liu C.Y., Apuzzo M.L. Surgery of the mind, mood and conscious state: an idea in evolution // World Neurosurg. – 2012. – Vol. 77. – P. 662-686.

29. Leksell L. Stereotactic Radiosurgery // Journal of Neurology Neurosurgery and Psychiatry. – 1983. – Vol. 46, № 9. – P. 797-803.

30. Pussep L.M. O vliyanii rentgenovskikh luchey na vozbudimost' mozgovoy kory // Otchety nauchnykh sobraniy vrachey Sankt-Peterburgskoy kliniki dushevnykh i nervnykh bolezney za 1897- 1898 gg. – SPb, 1899. - S. 63.

31. Korzenev A.V., Abritalin Ye.YU. Preodoleniye rezistentnosti depressivnykh rasstroystv metodom neyroelektrostimulyatsii // Byulleten' SO RAMN. – 2010. – T. 30, № 5. – S. 30-34.

32. Babel T.B., Warnke P.C., Ostertag C.B. Immediate and long term outcome after infrathalamic and thalamic lesioning for intractable Tourette's syndrome // J. Neurol. Neurosurg. Psychiatry.– 2001.–V. 70, № 5.– Р. 666–671.

33. Sachdev P., Trollor J., Walker A. Bilateral orbitomedial leucotomy for obsessive–compulsive disorder: a single-case study using positron emission tomography // Australian and New Zealand J. of Psychiatry. – 2001. – Vol. 35, № 5. – P. 684-690.

34. Shamrey V.K., Korzenev A.V., Abritalin Ye.YU. Ispol'zovaniye metodov funktsional'noy (stereotaksicheskoy) neyrokhirurgii v korrektsii malokurabel'nykh psikhicheskikh rasstroystv // Izbrannyye lektsii po klinicheskoy, ekstremal'noy i voyennoy psikhiatrii: uchebnoye posobiye. – M., 2007. – S. 324-338.

35. Sharova E.V., Gavron A.A., Abdulayev A.A. i dr. Opyt fMRT-analiza sostoyaniya po-koya (resting state) zdorovykh ispytuyemykh s ispol'zovaniyem programmnogo obespecheniya FSL // Meditsinskaya vizualizatsiya. – 2015. – № 4. – S. 6-17.

36. Sheffield J.M., Kandala S., Tamminga C.A. et al. Transdiagnostic Associations Between Functional Brain Network Integrity and Cognition // JAMA Psychiatry. – 2017. – Vol. 74, № 6. – Р. 605-613.

37. Accolla E.A., Aust S., Merkl A. et al. Deep brain stimulation of the posterior gyrus rectus region for treatment resistant depression // Journal of Affective Disorders. – 2016. – Vol. 194. – P. 33–37.

38. Dougherty D.D., Rezai A.R., Carpenter L.L. et al. A Randomized Sham-Controlled Trial of Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Chronic