Research — 05 January 2015

High-intensity focused ultrasound may help relieve symptoms of obsessive-compulsive disorder (OCD) in hard-to-treat patients, according to preliminary findings of new research.

The procedure applies high-intensity focused ultrasound energy to heat and destroy diseased or damaged tissue through ablation (the removal of tissue).

The study is being conducted with 12 patients by Jin Woo Chang, M.D., Ph.D., at the Yonsei University Medical Center in Seoul, Korea. The results of the first four patients with six months follow-up were published in the Journal of Molecular Psychiatry.

Although many OCD patients improve with medication, some patients have debilitating symptoms that are resistant to treatment. For these patients, psychosurgery can be performed to destroy (ablate) a targeted region of the brain (anterior internal capsule) associated with the disorder.

The four patients, who suffered from disabling OCD that was unresponsive to medication, were treated with a focused ultrasound system called InSightec ExAblate Neuro. The treatment targeted the part of the brain called the anterior internal capsule.

All four patients had the targeted areas of the brain successfully ablated with no complications or side effects. They experienced gradual improvements in their obsessive-compulsive thoughts and behaviors and showed nearly immediate and sustained improvement in depression and anxiety which lasted over six months.brain

“There is a need for non-invasive treatment options for patients with OCD that cannot be managed through medication,” said Chang.

“Using focused ultrasound, we were able to reduce the symptoms for these patients and help them get some of their life back without the risks or complications of the more invasive surgical approaches that are currently available.”

“If these initial results are confirmed in the remaining eight patients in this study as well as in a larger pivotal trial of safety and efficacy, focused ultrasound could emerge as an alternative to surgery for improving quality of life in a cost-effective manner for patients with OCD,” said Neal F. Kassell, M.D., chairman of the Focused Ultrasound Foundation.

“This could also serve as the predicate for non-invasive therapy for other psychiatric disorders.”

The currently available ablative approaches are invasive or involve radiation, such as radiofrequency ablation, stereotactic radiosurgery, and deep brain stimulation.

Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by recurring anxiety-provoking thoughts (obsessions) that are alleviated only by ritualistic actions (compulsions). Severe cases can lead to overwhelming impairment and dysfunction.

OCD patients also have a high risk for depression, with two-thirds of OCD patients developing major depression. Chang plans to begin a study using focused ultrasound to treat depression in 2015.

This article first appeared on ‘Psych Central’ on 2 January 2015.

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