AsianScientist (Mar. 26, 2025) – A group of researchers from South Korea has shown that a new non-invasive procedure, called magnetic resonance-guided focused ultrasound (MRgFUS) capsulotomy can potentially help in treating Obsessive-Compulsive Disorder (OCD). The research, published in Molecular Psychiatry, showed that the results of the treatment can last up to two years.
People OCD experience frequent unwanted thoughts and obsessions that cause them to perform compulsive, repetitive behaviors such as constantly cleaning their house. These repetitive behaviors can significantly interfere with social interactions and performing daily tasks.
In China, about 1.6 percent of people are affected by OCD in their lifetime, while in Singapore, the rate is around 3 percent.
This condition often resists standard treatments which can make the condition long-lasting and hard to treat, greatly affecting the quality of life. Usually, when non-invasive therapies for psychiatric conditions fail, brain surgery is the only option. Bilateral capsulotomy or deep brain stimulation (DBS) is a key surgery for treating severe OCD. It works by cutting or electrically stimulating the brain’s white matter that links the prefrontal cortex and thalamus.
However, brain surgery increases risks like infection and bleeding and can accidentally damage nearby brain tissue.
Ten patients who had MRgFUS capsulotomy at Severance Hospital between 2013 and 2014 and were part of a clinical trial that tested how well MRgFUS works for severe OCD were enrolled in the study.
For two years after surgery, they stayed on the same medications. After that, doctors adjusted medications based on symptoms. Though they didn’t receive formal cognitive behavioral therapy after MRgFUS, they were encouraged to use the Cognitive Behavioral Therapy skills they had learned earlier.
The improvements seen two years after the surgery continued or improved after 10 years. In addition to the surgery, ongoing medication adjustments and the use of cognitive-behavioral skills may have helped improve outcomes.
After 10 years, 70% of patients responded well to the surgery, and two were in remission. MRgFUS showed slightly better or comparable results to other surgeries, like gamma knife, radiofrequency (RF) capsulotomy, and deep brain stimulation (DBS).
Most patients expressed satisfaction with the surgery which was linked to how much their OCD symptoms improved.
According to the researchers, compared to other surgical methods, MRgFUS has clear advantages as it does not cause major side effects. Some patients even reported improved frontal lobe functions such as decision-making, problem-solving, impulse control, and emotional regulation.
“These studies involve the world’s first clinical trial for OCD with MRgFUS. The current study is also the world’s first long-term follow-up study for OCD after treatment,” said Jin Woo Chang, Professor, Korea University Anam Hospital and the lead researcher of the study.
According to Chang, the application of MRgFUS capsulotomy may not be just limited to refractory OCD.
“The results from our clinical trial also imply the potential role of MRgFUS in managing other common psychiatric diseases, such as refractory depression, due to its simplicity and safety,” he said.
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Source: Korea University College of Medicine ; Image: Shutterstock
The article can be found at: Long-term clinical outcome of a novel bilateral capsulotomy with focused ultrasound in refractory obsessive-compulsive disorder treatment
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