Cingulotomy

Cingulotomy refers to a neurosurgical procedure that involves the targeted destruction of a specific region of the brain known as the cingulate gyrus. This region is associated with the experience of negative emotions, including anxiety, depression, and obsessive-compulsive disorder (OCD). Cingulotomy is typically performed as a treatment option for individuals who have not found relief from other forms of therapy.

Procedure

The cingulotomy procedure involves the use of stereotactic neurosurgery, in which a 3D coordinate system is used to precisely guide the surgical instruments. The patient is usually awake during the procedure, as this allows the surgical team to monitor the effects in real time.

The surgeon creates a small opening in the skull to access the cingulate gyrus. Using either radiofrequency ablation or the insertion of electrodes, the surgeon then applies targeted lesions or delivers electrical currents to interrupt the neural circuitry in the cingulate gyrus.

Indications

Cingulotomy is primarily indicated for individuals suffering from severe and treatment-resistant psychiatric disorders, specifically:

• Anxiety Disorders: Cingulotomy can be considered as a treatment option for individuals with debilitating anxiety disorders, such as generalized anxiety disorder (GAD) or post-traumatic stress disorder (PTSD), who have not responded to other therapies.
• Depression: In cases where conventional treatments, such as psychotherapy and medication, have failed to alleviate depression symptoms, cingulotomy may be recommended.
• Obsessive-Compulsive Disorder (OCD): Cingulotomy can be considered for individuals with severe OCD symptoms that are resistant to other forms of treatment.

Outcome and Risks

The effects of cingulotomy vary depending on the individual, and not all patients experience the same benefits. Some potential outcomes include a reduction in the intensity of negative emotions, decreased anxiety, improved mood, and a decrease in the frequency and severity of OCD symptoms.

As with any surgical procedure, cingulotomy carries certain risks and potential side effects. These may include infection, bleeding, memory and cognitive changes, personality alterations, and physical discomfort. It is essential for individuals considering cingulotomy to consult with their healthcare provider to determine if the potential benefits outweigh the risks.