Personality measures after gamma ventral capsulotomy in intractable OCD

Prog Neuropsychopharmacol Biol Psychiatry. 2018 Feb 2:81:161-168. doi: 10.1016/j.pnpbp.2017.10.023. Epub 2017 Nov 1.

Abstract

Background: Neurosurgeries such as gamma ventral capsulotomy (GVC) are an option for otherwise intractable obsessive-compulsive disorder (OCD) patients. In general, clinical and neuropsychological status both improve after GVC. However, its consequences on personality traits are not well-studied. The objective of this study was to investigate personality changes after one year of GVC in intractable OCD patients.

Methods: The personality assessment was conducted using the Revised NEO Personality Inventory (NEO PI-R) and Cloninger's Temperament and Character Inventory (TCI) in 14 intractable OCD patients before and one year after GVC. Comparisons of personality features between treatment responders (n=5) and non-responders (n=9) were performed. Multiple linear regression was also used for predicting changes in clinical and global functioning variables.

Results: Overall, no deleterious effect was found in personality after GVC. Responders had a reduction in neuroticism (p=0.043) and an increase in extraversion (p=0.043). No significant changes were observed in non-responders. Increases in novelty seeking and self-directedness, and decreases in persistence and cooperativiness predicted OCD symptom improvement. Similary, improvement in functioning was also predicted by hgher novelty seeking and self-directedness after GVC, whereas better functioning was also associated with lower reward dependence and cooperativeness after surgery.

Conclusions: The pattern of changes in personality traits after GVC was generally towards that observed in nonclinical population, and does not raise safety concerns.

Keywords: Extraversion; Gamma ventral capsulotomy; Neuroticism; Obsessive-compulsive disorder; Personality; Radiosurgery.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Internal Capsule / radiation effects
  • Linear Models
  • Male
  • Obsessive-Compulsive Disorder / psychology*
  • Obsessive-Compulsive Disorder / therapy*
  • Personality Inventory
  • Personality*
  • Psychiatric Status Rating Scales
  • Radiosurgery
  • Treatment Outcome