Clinical Observation On And Prevention From Impaired Short-term Cognitive Function In Patients With Refractory Obsessive Compulsive Disorder Following Stereotactic Surgery

Objective:To observe the change of short term cognitive function in patients following anterior capsulotomy and deep brain stimulation of nucleus acumbens.To observe the effect of exogenous phosphocreatine on short term cognitive function in patients with obsessive compulsive disorder following stereo tactic capsulotomy.Methods:Sixty-two patients with obsessive compulsive disorder were randomly divided into treated group and control group after anterior capsulotomy. Another six patients with severe, refractory obsessive compulsive disorder who failed to conventional therapy underwent deep brain stimulation of bilateral nucleus accumbens. DBS electrodes were implanted by MRI guided stereotactic surgery for continuous stimulation The patients in treated group were given exogenous phosphocreatine besides conventional therapy. The efficacy was evaluated using Mini Mental State Examination(MMSE),WAIS—RC and WMS before and1,7,30days postoperation. Wisconsin card sorting test (WCST) were used to assess the executive function.Results:There was significant difference between the obsessive compulsive disorders and normal contrast in the cognitive function. Short—term cognitive function after stereotactic anterior capsulotomy was impaired. Short—term cognitive function returned to normal in7days in exogenous phosphocreatine treated group.The side effect reduced significant in therapy group. Conclusions Exogenous phosphocreatine could accelerate the recovery of cognitive function in patients with refractory obsessive compulsive disorder following stereotactic capsulotomy and reduce the side effect of anterior capsulotomy. Stereotactic capsulotomy could improve some cognitive function such as executive function in long term. Deep brain stimulation of bilateral nucleus accumbens can improve the symptom of obsession,anxiety,depression with less side effect.The deep brain stimulation of nucleus acumbens did not impair the short term cognitive function in OCD patients following surgery.It could improve some cognitive function such as PIQ and executive function in long term.