- Last Updated: November 17, 2017
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.
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.
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.
Bauer R, Martin E, Haegele-Link S, Kaegi G, von Specht M, Werner B. Noninvasive functional neurosurgery using transcranial MR imaging-guided focused ultrasound. Parkinsonism Relat Disord. 2014 Jan;20 Suppl 1:S197-9. doi: 10.1016/S1353-8020(13)70046-4.
Click here for additional references from PubMed.