Key Points
- 10-year results from Korea demonstrate that MR-guided focused ultrasound capsulotomy is safe and effective in patients with obsessive-compulsive disorder.
- Participants from a clinical trial conducted by Jin-Woo Chang, MD, PhD, reported significant improvements in function and significantly reduced symptoms.
Jin-Woo Chang, MD, PhD, pioneered modern MR-guided focused ultrasound (MRgFUS) psychiatric treatments in Korea. In 2013, he began a clinical trial for OCD, and the results were published in 2014.
Now, after a decade of follow-up, 10 of the 11 participants from that study were evaluated for long-term efficacy and safety. To measure the effectiveness of the treatment, researchers administered the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Frontal Systems Behavior Scale (FrSBe), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), and a locally developed MRgFUS-patient-centered outcomes questionnaire.
The Y-BOCS scores showed a mean improvement of 52.3%. After 10 years, seven participants still showed a response to the treatment and two participants achieved remission of the OCD symptoms. This finding is interesting given the results from the two-year assessment, which showed six responders, two partial responders, and only one participant in remission. The treatment also was specific to the OCD symptoms, as no changes from baseline were found in depression and anxiety symptoms at either the 2-year or 10-year assessments.
Together, Y-BOCS and Global Assessment of Functioning test scores showed that the treatment both significantly reduced OCD systems and improved function. FrSBe scores, which measure frontal-lobe-related function, also showed significant improvement. There were no adverse effects.
When asked about their satisfaction with the treatment using the MRgFUS-patient-centered outcomes questionnaire, the nine participants who responded to the questionnaire all scored undergoing MRgFUS capsulotomy as the correct decision and said that they would choose to undergo the procedure again.
Eyal Zadicario, Insightec’s chief operating officer and general manager congratulated Dr. Chang, saying “The pioneering spirit to start OCD in 2013 – together with the tenacity to follow up patients for 10 years – is incredible. This spirit is what will make focused ultrasound a huge success in multiple applications in the future.”
The research group concluded that MRgFUS capsulotomy is an effective, safe treatment option for severe treatment-refractory OCD and that the procedure had a durable efficacy after 10 years.
These data, together with similar results from the research team at Sunnybrook Health Sciences Centre in Toronto that is led by Nir Lipsman, MD, PhD, demonstrate that MRgFUS capsulotomy should be considered as a long-term treatment option for OCD.
Dr. Chang’s study was funded by the Focused Ultrasound Foundation.
See “Long-Term Clinical Outcome of a Novel Bilateral Capsulotomy with Focused Ultrasound in Refractory Obsessive-Compulsive Disorder Treatment” in Molecular Psychiatry