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Obsessive-compulsive disorder and focused ultrasound

Strips of the word "obsessive-compulsive disorder" are laid behind the acronym OCD.
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Written by Jennifer Palisoc

OCD affects one in 40 people, over the course of their lifetime. This psychiatric illness can affect people of any age and from all walks of life.

Patients living with OCD experience a cycle of obsessions, intrusive, and unwanted thoughts or urges that lead to repetitive actions or behaviours called compulsions.

Treatment can include psychotherapy, medication, inpatient, outpatient, or residential treatment options. Approximately 20 per cent of patients do not respond to conventional treatment and are diagnosed with treatment-resistant OCD.

Investigating a possible treatment option for OCD

Focused ultrasound (FUS) is being studied in a North American first trial for treatment-resistant obsessive-compulsive disorder (OCD). The study is investigating safety of this treatment and began in 2017.

FUS is an incision-free, image-guided technology that uses ultrasound waves to target parts of the brain.

In this trial, FUS is used to cause a lesion and disrupt a specific brain pathway in a region of the brain called the Anterior Limb of the Internal Capsule, or ALIC, which is active in OCD.

“This ‘highway’ of fibres is critical in connecting the frontal lobe to deeper structures that we know are important for anxiety, mood and decision-making,” explains Dr. Nir Lipsman, principal investigator and director of Sunnybrook’s Harquail Centre for Neuromodulation. “By targeting this pathway, the goal is to help ‘reset’ this part of the brain and improve communication.”

Study: Focused ultrasound for OCD

Since the study began, eight patients with OCD have been treated with FUS. Researchers say while they are still in the preliminary stages of their investigation, results are promising so far.

“Our early data suggest that at least 50 per cent of patients experience a significant improvement in OCD symptoms by the 12-month follow-up,” says Dr. Benjamin Davidson, neurosurgical resident and study team member.

“It’s important to emphasize that each patient responds differently to treatment,” explains Dr. Davidson. “It may take many months for some patients to notice a difference in symptoms, while other patients may not experience any changes.”

Researchers say FUS is not a treatment solution on its own and it’s important for patients to work with their health care team to determine an appropriate treatment plan that may include medication, psychotherapy and other treatment options.

“We view focused ultrasound as part of a larger more comprehensive treatment strategy where patients continue getting treatment, and potentially go on to residential treatment, and continue seeing a psychiatrist,” says Dr. Lipsman.

Read about the first patient in North America to participate in this trial investigating the safety of using FUS to treat OCD.

Currently, Canadians between the ages of 20 to 80 years old are eligible to participate in this trial. Ten participants will undergo a round of focused ultrasound and participate in a series of assessments at certain points in the year following treatment.

“If you are interested in learning more about the focused ultrasound clinical trial for OCD, speak with your psychiatrist and your primary care physician about whether this is appropriate for you and your care,” says Dr. Lipsman.


About the author

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Jennifer Palisoc

Jennifer Palisoc is a Communications Advisor at Sunnybrook.

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