Depression

Focused Ultrasound Therapy

Outside Approval Square Focused ultrasound is an early stage, noninvasive therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with depression. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces a variety of therapeutic effects enabling treatment without incisions or radiation.

Current treatments for depression include medications, electroconvulsive therapy, surgery (radiofrequency or laser ablation, deep brain stimulation), or stereotactic radiosurgery (gamma knife, linear accelerator), all of which have limitations and side effects. Focused ultrasound has the potential to provide an alternative to invasive surgery or radiosurgery via precise thermal ablation, or to augment drug therapy.

Clinical Trials SquarePotential advantages:

  • Focused ultrasound is non-invasive – no incisions, holes in the skull, electrodes in the brain – and therefore has reduced risk for infection and blood clots.
  • Precise targeting minimizes damage to non-targeted healthy brain.
  • Treatment can be a complement to drug therapy, enabling enhanced delivery of therapies into the brain via temporary opening of the blood-brain barrier.

Clinical Trials

A clinical trial consisting of ten patients at the YUMC Severance Hospital in Seoul, Korea evaluated the feasibility, safety and initial efficacy of focused ultrasound in the treatment of major depressive disorder for patients who are not candidates for, or who choose not to undergo, more invasive procedures.

See here for a list of treatment sites
See here for a list of clinical trials sites
See here for a list of laboratory research sites

Regulatory Apprroval and Reimbursement

Focused ultrasound is not approved by any regulatory bodies worldwide as a treatment for depression, nor is the treatment reimbursed by medical insurance providers.

Additional Resources

National Institute of Mental Health
One Mind
Depression and Bipolar Support Alliance

Notable Papers

Volpini M, Giacobbe P, Cosgrove GR, Levitt A, Lozano AM, Lipsman N. The History and Future of Ablative Neurosurgery for Major Depressive Disorder. Stereotact Funct Neurosurg. 2017 Jul 20;95(4):216-228. doi: 10.1159/000478025.

Kim M., Kim C.-H., Jung H.H., Kim S.J. & Chang J.W. Treatment of major depressive disorder via magnetic resonance–guided focused ultrasound surgery. Biological Psychiatry (2017), doi: 10.1016/j.biopsych.2017.05.008.

Tsai SJ. Transcranial focused ultrasound as a possible treatment for major depression. Med Hypotheses. 2015 Apr;84(4):381-3. doi: 10.1016/j.mehy.2015.01.030. Epub 2015 Jan 31.

Jung HH, Kim SJ, Roh D, Chang JG, Chang WS, Kweon EJ, Kim CH, Chang JW. Bilateral thermal capsulotomy with MR-guided focused ultrasound for patients with treatment-refractory obsessive-compulsive disorder: a proof-of-concept study. Mol Psychiatry. 2015 Oct;20(10):1205-11. doi: 10.1038/mp.2014.154. Epub 2014 Nov 25.

Trevor A. Hurwitz., et al., Bilateral anterior capsulotomy for intractable depression. J Neuropsychiatry Clin Neurosci 2012.24(2): p. 176-182

Andrade, P., et al., Neurostimulatory and ablative treatment options in major depressive disorder: a systematic review. Acta Neurochir, 2010.152: p. 565-577.

M. Sam Eljamel, et al., Ablative neurosurgery for mental disorder: is there still a role in the 21st century? A personal perspective. Neurosurg Focus, 2008. 25(1): p.1-6

Click here for additional references from PubMed.