by Korea University College of Medicine

Periodic changes of MRgFUS capsulotomy lesion size. Credit: Molecular Psychiatry (2024). DOI: 10.1038/s41380-024-02799-9

When conventional non-invasive treatments for psychiatric diseases fail, clinicians inevitably have to consider brain surgery. However, brain surgery for psychiatric diseases has long been taboo among the general public due to the infamous history of lobotomy. Thankfully, advancements in brain surgery in recent years are changing the narrative.

Bilateral capsulotomy, more commonly known as deep brain stimulation, is a form of brain surgery that has been garnering attention in treating treatment-resistant or refractory obsessive-compulsive disorder (OCD). Patients with refractory OCD experience a debilitating degree of repetitive behaviors and thoughts that they are unable to control, thus downgrading their quality of life.

A group of researchers from South Korea demonstrated that a novel non-invasive bilateral capsulotomy called magnetic resonance-guided focused ultrasound (MRgFUS) capsulotomy is efficacious and safe in treating refractory OCD for up to two years. MRgFUS capsulotomy non-invasively and precisely ablates tissues in the brain region of interest. However, the sustained efficacy of this treatment option was unclear.

Recently, the same research group conducted a long-term follow-up study of 10 years involving patients with refractory OCD who underwent MRgFUS capsulotomy. They reported that MRgFUS capsulotomy is an efficacious and safe treatment option for refractory OCD, with high patient satisfaction, even at 10 years, establishing its lasting positive effects in patients. Their findings were published in Molecular Psychiatry on October 28, 2024.

This study has achieved multiple milestones in OCD research, offering hope to many patients experiencing refractory OCD. Accordingly, Dr. Jin Woo Chang from Korea University Anam Hospital who is a lead researcher in the study, says, "These studies involve the world's first clinical trial for OCD with MRgFUS. The current study is also the world's first long-term follow-up study for OCD after treatment."

Interestingly, the application of MRgFUS capsulotomy may not be just limited to refractory OCD. Dr. Chang says, "The results from our clinical trial also imply the potential role of MRgFUS in managing other common psychiatric diseases, such as refractory depression, due to its simplicity and safety."

With the clinical application of MRgFUS capsulotomy on the horizon, Dr. Chang concludes, "With the rapid development of new surgical techniques like MRgFUS, it is possible to cure psychiatric diseases without additional complications. I am convinced this new technology will offer a new lease of life for those suffering and struggling from serious psychiatric problems."

More information: Kyung Won Chang et al, Long-term clinical outcome of a novel bilateral capsulotomy with focused ultrasound in refractory obsessive-compulsive disorder treatment, Molecular Psychiatry (2024). DOI: 10.1038/s41380-024-02799-9

Journal information: Molecular Psychiatry 

Provided by Korea University College of Medicine