广泛使用深部脑刺激(DBS)治疗运动障碍,重新引起了人们对DBS治疗精神疾病的兴趣。LauriLaitinen是1950年代至1970年代立体定向心理外科的先驱,特别是通过引入亚指扣带切开术。我们的目的是验证莱蒂宁使用的解剖目标,报告接受此手术的患者,并回顾文献。
在赫尔辛基大学医院的记录中搜索了1970年至1974年之间进行的心理外科病例。对活着的同意的患者进行了访谈,并进行了脑部MRI检查。
我们发现1名在世的病人在1971年因强迫性思维而接受了先天性扣带切开术,焦虑,和强迫,当时被诊断为“精神分裂症精神神经症”。MRI显示双侧下系带切开术病变(分别为254和160mm3)。病变中心相对于左右连合点的坐标,分别,分别为:横向7.1和7.9毫米;下部0.2毫米,上部1.4毫米,前33.0和33.9,确认正确的亚基因靶向。患者报告回顾性结果满意。
发现该患者的病变位于预期位置,这对Laitinen亚属扣带切开术目标的正确放置进行了一些验证。
The widespread use of deep brain stimulation (DBS) for movement disorders has renewed the interest in DBS for psychiatric disorders. Lauri Laitinen was a pioneer of stereotactic psychosurgery in the 1950s to 1970s, especially by introducing the subgenual
cingulotomy. Our aim here was to verify the anatomical target used by Laitinen, to report on a patient who underwent this procedure, and to review the literature.
The records of Helsinki University Hospital were searched for psychosurgical cases performed between 1970 and 1974. Alive consenting patients were interviewed and underwent a brain MRI.
We found 1 patient alive who underwent subgenual
cingulotomy in 1971 for obsessive thoughts, anxiety, and compulsions, diagnosed at that time as \"schizophrenia psychoneurotica.\" MRI showed bilateral subgenual
cingulotomy lesions (254 and 160 mm3, respectively). The coordinates of the center of the lesions in relation to the midcommissural point for the right and left, respectively, were: 7.1 and 7.9 mm lateral; 0.2 mm inferior and 1.4 mm superior, and 33.0 and 33.9 anterior, confirming correct subgenual targeting. The patient reported retrospective satisfactory results.
The lesion in this patient was found to be in the expected location, which gives some verification of the correct placement of Laitinen\'s subgenus
cingulotomy target.