PT620. A pilot study of bilateral thermal capsulotomy with focused ultrasound for treatment-refractory (MRgFUS) obsessive-compulsive disorder
Year: 2016
Type: conference-abstract
Abstract: Objective: Although cognitive-behavioral therapy and SSRIs is standard therapeutic approach, many OCD patients do not respond adequately. For those patients, an alternative approach of various neurosurgical interventions has been applied. In recent, a new thermal lesioning approach of MRgFUS was introduced to various neurological and psychiatric conditions. Therefore, we evaluated the efficacy and adverse effects of MRgFUS for refractory OCD. Methods: Eleven refractory OCD patients were treated with MRgFUS to ablate the anterior limb of the internal capsule. Patients underwent neuropsychological evaluations at 1 week, 1, 3, 6, and 12 months follow up. Outcomes were measured with the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A), and adverse events were evaluated. Results: The Y-BOCS (χ2=43.13, p<0.001) HAM-D (χ2=28.67.12, p<0.001), and HAM-A (χ2=24.66, p<0.001) scores decreased significantly from baseline to the end of the 12 months. The mean Y-BOCS score at baseline was 34.36 ± 2.35 and decreased to 21.82 ± 4.79 at the 12 months follow up. Compared with the baseline, the average Y-BOCS score decreased 11.90%, 17.99%, 24.60%, 31.22%, and 36.51% by the 1 week, 1, 3, 6, and 12 month time points, respectively. At the 12 months follow up, 6 (54.55%) and 3 (27.27%) patients were in response and in partial response, respectively. The mean HAM-D score at baseline was 19.00 ± 5.29, which decreased to 8.91 ± 5.39 at the 12-month time point. The mean HAM-A score at baseline was 22.36 ± 5.94, which decreased to 8.55 ± 4.93 at the 12-month time point. Compared with baseline, overall neuropsychological functions were stable or improved over time. During sonication period, some patients felt transient, mild headaches, nausea, vomiting or dizziness. No demonstrable physical, neurological or psychological persistent complications occurred. Conclusions: The bilateral thermal capsulotomy with MRgFUS may be an effective alternative treatment for refractory OCD.
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,693
OpenAlex ID: W2807910809