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Brain Variations on MRI May Predict Surgical Success in OCD

Features of anterior cingulate cortex structure, connectivity appear to predict surgical success

WEDNESDAY, Dec. 24, 2014 (HealthDay News) -- Doctors may be able to identify candidates for dorsal anterior cingulotomy for refractory obsessive-compulsive disorder (OCD) by looking at a key structure in the targeted brain region. These research findings have been published online Dec. 23 in JAMA Psychiatry.

In the study, investigators conducted magnetic resonance imaging scans of 15 refractory OCD patients, all of whom had undergone cingulotomy surgery. The team, led by Garrett Banks of Columbia University in New York City, found that only about half (eight patients) had responded positively to the procedure.

The researchers found that features of anterior cingulate cortex structure and connectivity predicted clinical response to the procedure. "These variations may allow us to predict which patients are most likely to respond to cingulotomy, thereby refining our ability to individualize this treatment for refractory psychiatric disorders," the authors write.

In an accompanying editorial, one Dutch expert said such a preoperative test might save patients unnecessary trauma, and save health care dollars. "If reliable predictive markers are identified…treatments might be offered only to patients with a predicted good outcome, thereby preventing unnecessary costs and iatrogenic damage in the remaining patients," Odile van den Heuvel, M.D., Ph.D., of the VU University Medical Center in Amsterdam, writes in the editorial.

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