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Acta Neurochirurgica
Published in: Acta Neurochirurgica 1/2017

01-01-2017 | Case Report - Functional

Gamma-knife subcaudate tractotomy for treatment-resistant depression and target characteristics: a case report and review

Authors: Seong-Cheol Park, Jung Kyo Lee, Chan-Hyung Kim, Jin Pyo Hong, Do Hee Lee

Published in: Acta Neurochirurgica | Issue 1/2017

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Abstract

Stereotactic subcaudate tractotomy has previously been suggested to be an effective treatment for depression. This is the first study to report the use of gamma-knife subcaudate tractotomy for treatment-resistant depression. A 49-year-old woman with major depressive disorder had been treated for 30 years, with nine suicide attempts during that time. The right and left target maximum diameter was 11 mm within 50 % isodose lines. The target was located more posteriorly and inferiorly than the subgenual cingulate target typically used for deep-brain stimulation. The maximum radiation dose was 130 Gy. During the 4 months after surgery, the patient improved gradually from 23 to 4 according to the Hamilton Rating Scale for Depression and antidepressant medication was discontinued. Target-sized focal lesions were identified and no edema was seen postoperatively. No aggravation or neurologic deficit occurred during the 2.5 years of follow-up. Gamma-knife subcaudate tractotomy for depression is a minimally invasive technique. Investigations of the effectiveness and safety profile in a larger group are warranted.
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Metadata
Title
Gamma-knife subcaudate tractotomy for treatment-resistant depression and target characteristics: a case report and review
Authors
Seong-Cheol Park
Jung Kyo Lee
Chan-Hyung Kim
Jin Pyo Hong
Do Hee Lee
Publication date
01-01-2017
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 1/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-016-3001-3

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