Focused Ultrasound Therapy
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 obsessive compulsive disorder (OCD). 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 OCD include medications, 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.
- 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.
A pilot clinical trial conducted at Yonsei University College of Medicine used focused ultrasound to perform bilateral anterior limb capsulotomies in OCD patients, all of which were refractory to medical therapy. The results of the first four patients with six months follow-up were recently published. These patients experienced gradual improvement in obsessive-compulsive thoughts and behaviors and showed sustained improvement in depression and anxiety over six months. The remaining patients in this study have been treated, and results will be published soon.
A second clinical trial has begun to treat OCD patients in Toronto, Canada. This study can only treat Canadian citizens. To inquire about this trial, please contact Anusha Baskaran at 416-480-6100 ext. 1650 or .
Regulatory Approval and Reimbursement
Focused ultrasound is not approved by any regulatory bodies worldwide as a treatment for OCD, nor is the treatment reimbursed by medical insurance providers.
Kim SJ, Roh D, Jung HH, Chang WS, Kim CH, Chang JW. A study of novel bilateral thermal capsulotomy with focused ultrasound for treatment-refractory obsessive-compulsive disorder: 2-year follow-up. J Psychiatry Neurosci. 2018 Aug;43(5):327-337.
Jung HH, Chang WS, Kim SJ, Kim CH, Chang JW. The Potential Usefulness of Magnetic Resonance Guided Focused Ultrasound for Obsessive Compulsive Disorders. J Korean Neurosurg Soc. 2018 Apr 10. doi: 10.3340/jkns.2017.0505.004.
Gong F, Li P, Li B, Zhang S, Zhang X, Yang S, Liu H, Wang W. A study of cognitive function in treatment-refractory obsessive-compulsive disorder treated with capsulotomy. J Neurosurg. 2018 Feb;128(2):583-595. doi: 10.3171/2016.9.JNS152494. Epub 2017 Mar 24.
Chang WS, Jung HH, Zadicario E, Rachmilevitch I, Tlusty T, Vitek S, Chang JW. Factors associated with successful magnetic resonance-guided focused ultrasound treatment: efficiency of acoustic energy delivery through the skull. J Neurosurg. 2016 Feb;124(2):411-6. doi: 10.3171/2015.3.JNS142592.
Brown LT, Mikell CB, Youngerman BE, Zhang Y, McKhann GM 2nd, Sheth SA. Dorsal anterior cingulotomy and anterior capsulotomy for severe, refractory obsessive-compulsive disorder: a systematic review of observational studies. J Neurosurg. 2016 Jan;124(1):77-89. doi: 10.3171/2015.1.JNS14681. Epub 2015 Aug 7. Review.
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.
Jung HH, Chang WS, Rachmilevitch I, Tlusty T, Zadicario E, Chang JW. Different magnetic resonance imaging patterns after transcranial magnetic resonance-guided focused ultrasound of the ventral intermediate nucleus of the thalamus and anterior limb of the internal capsule in patients with essential tremor or obsessive-compulsive disorder. J Neurosurg. 2015 Jan;122(1):162-8. doi: 10.3171/2014.8.JNS132603.
Click here for additional references from PubMed.