Novel noninvasive surgical approach shows promise in treating severe OCD

Editor's Note

A new noninvasive procedure called magnetic resonance-guided focused ultrasound (MRgFUS) capsulotomy is showing promising results for patients with severe obsessive-compulsive disorder (OCD), Asian Scientist March 26 reports. In a study conducted by researchers in South Korea and published in Molecular Psychiatry, 10 individuals who received MRgFUS capsulotomy at Severance Hospital between 2013 and 2014 were followed for up to a decade. Impressively, 70% of patients responded well to the procedure, and two achieved remission.

OCD is characterized by unwelcome, persistent thoughts that lead sufferers to engage in repetitive, compulsive behaviors, often interfering with normal social activities and daily responsibilities. This disorder frequently resists conventional treatments, making surgical intervention one of the few remaining options in severe cases. Historically, brain surgical procedures such as bilateral capsulotomy or deep brain stimulation (DBS) have been used when noninvasive therapies fail. They are not without risk, however. These procedures may bring complications such as infection, bleeding, and potential damage to surrounding brain tissue. MRgFUS capsulotomy offers a less invasive alternative, reducing complications while effectively addressing OCD symptoms. Patients in the study continued their usual medications for 2 years post-surgery, with further adjustments made after that period based on individual symptoms.

Over the decade-long follow-up, the initial improvements remained stable or even improved. Beyond decreased OCD symptoms, participants reported enhanced frontal lobe functions—such as better decision-making, impulse control, and emotional regulation. The researchers note that in addition to the procedure itself, medication optimization and the application of cognitive-behavioral skills may have significantly contributed to these long-term positive outcomes.

MRgFUS showed equal or even superior effectiveness compared to other surgical interventions like gamma knife procedures, radiofrequency capsulotomy, and DBS. Most patients expressed satisfaction, which correlated with the degree to which their symptoms diminished. “The results from our clinical trial also imply the potential role of MRgFUS in managing other common psychiatric diseases, such as refractory depression,” lead researcher Jin Woo Chang, MD, PhD, professor at Korea University Anam Hospital, told the outlet.