TRATAMIENTO POR TERMOCOAGULACIÓN PARA TRASTORNO OBSESIVO-COMPULSIVO Y SÍNDROME DE DEPENDENCIA A DROGAS: UN INFORME DE CASO
DOI:
https://doi.org/10.47820/recima21.v6i1.6481Palabras clave:
Neurocirugía; Salud mental; Trastorno obsesivo-compulsivo.Resumen
En este informe de caso, se describe el tratamiento mediante un procedimiento quirúrgico estereotáxico utilizando termocoagulación en un paciente con trastorno obsesivo-compulsivo (TOC) refractario y dependencia de drogas. El paciente, de sexo masculino, de 37 años de edad, presentaba antecedentes de dependencia química, trastorno bipolar, trastorno por déficit de atención con hiperactividad y TOC resistente al tratamiento convencional. Tras la cirugía, realizada en noviembre de 2022 con el objetivo de desactivar regiones cerebrales hiperactivas asociadas a los síntomas, el paciente no presentó signos de abstinencia y refirió una mejora sustancial en su calidad de vida, incluyendo la interrupción del consumo de cocaína. Estos resultados indican la eficacia de la neuroablación en este contexto, ofreciendo una opción terapéutica prometedora para pacientes con TOC refractario y dependencia química como comorbilidad.
Descargas
Referencias
1 World Health Organization. ICD-11: International Classification of Diseases for Mortality and Morbidity Statistics. 11th Revision. Geneva: World Health Organization; 2024.
2 Abreu P, Prada C. Relação entre os condicionamentos operante e respondente no transtorno obsessivo-compulsivo. Estud Psicol. 2005;22(03):225–232. DOI: https://doi.org/10.1590/S0103-166X2005000300001
3 Torres AR, Ramos-Cerqueira AT, Ferrão YA, Fontenelle LF, Rosário MC do Miguel EC. Suicidality in obsessive-compulsive disorder: prevalence and relation to symptom dimensions and comorbid conditions. J Clin Psychiatry. 2011;72(01):17–26. DOI: https://doi.org/10.4088/JCP.09m05651blu
4 American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5™. 5th ed. Washington, DC: American Psychiatric Association; 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596
5 Costa DLC, Diniz JB, Requena G, et al. Randomized, double-blind, placebo-controlled trial of N-acetylcysteine augmentation for treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry. 201778(07):e766–e773. DOI: https://doi.org/10.4088/JCP.16m11101
6 De Crescenzo F. Ciabattini M, D'Alò GL, et al. Comparative efficacy and acceptability of psychosocial interventions for individuals with cocaine and amphetamine addiction: A systematic review and network meta-analysis. PLoS Med. 2018;15(12):e1002715. DOI: https://doi.org/10.1371/journal.pmed.1002715
7 Ducharme S, Price BH, Dougherty DD. Neurosurgical ablative procedures for psychiatric disorders. In: Camprodon JA, Rauch SL, Greenberg BD, Dougherty DD, editors. Psychiatric neurotherapeutics: contemporary surgical and device-based treatments. New York: Humana Press; 2016:117–139. DOI: https://doi.org/10.1007/978-1-59745-495-7_6
8 Guisolphi N, Bessa I, Silva L. Thermocoagulation treatment of a patient with obsessive compulsive disorder and substance use disorder: case report. Braz Neurosurg. 2022;41(02):e212–e216. DOI: https://doi.org/10.1055/s-0041-1740166
9 World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Med Assoc. 2013;310(20):2191–2194. DOI: https://doi.org/10.1001/jama.2013.281053
10 Paula FDR, Prado MWX, Rovere LVV. Neurocirurgia psiquiátrica: a história de tratamento dos transtornos mentais por meio de cirurgia cerebral. Sictec 2023;24(09):1-5Yen C, Lin CL, Chiang MC. Exploring the frontiers of neuroimaging: a review of recent advances in understanding brain functioning and disorders. Life. 2023;13(07):1472. DOI: https://doi.org/10.3390/life13071472
11 Cabrera LY, Courchesne, C, Kiss ZHT, Illes J. Clinical perspectives on psychiatric neurosurgery. Stereotact Funct Neurosurg. 2019;97(05–06):391–398. DOI: https://doi.org/10.1159/000505080
12 Mustroph ML, Cosgrove GR, Williams ZM. The evolution of modern ablative surgery for the treatment of obsessive-compulsive and major depression disorders. Front Integr Neurosci. 2022;16:797533 DOI: https://doi.org/10.3389/fnint.2022.797533
13 Chang JG, Kim SJ, Kim CH. Neuroablative intervention for refractory obsessive-compulsive disorder. Psychiatry Investig. 2023;20(11):997–1006. DOI: https://doi.org/10.30773/pi.2023.0214
14 Lai Y, Wang T, Zhang C, et al. Effectiveness and safety of neuroablation for severe and treatment-resistant obsessive–compulsive disorder: a systematic review and meta-analysis. J Psychiatry Neurosci. 2020;45(05):356–369. DOI: https://doi.org/10.1503/jpn.190079
15 Kumar KK, Appelboom G, Lamsam L, et al. Comparative effectiveness of neuroablation and deep brain stimulation for treatment-resistant obsessive-compulsive disorder: a meta-analytic study. J Neurol Neurosurg Psychiatry. 2019;90(04):469–473. DOI: https://doi.org/10.1136/jnnp-2018-319318
16 Zhang C, Zhang Y, Li D, et al. Habenular stimulation for neurosurgery resistant obsessive-compulsive disorder: a case report. Front Psychiatry. 2020;11:29. DOI: https://doi.org/10.3389/fpsyt.2020.00029
Descargas
Publicado
Número
Sección
Categorías
Licencia
Derechos de autor 2025 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.
