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Abstract Details

MR-guided Focused Ultrasound Capsulotomy for Treatment-Resistant Obsessive Compulsive Disorder and Major Depressive Disorder
General Neurology
P2 - Poster Session 2 (11:45 AM-12:45 PM)
7-004

The aim is to systematically assess the therapeutic effectiveness and safety of MRgFUS in individuals with refractory obsessive–compulsive disorder (OCD) and major depressive disorder (MDD).

Magnetic resonance–guided focused ultrasound (MRgFUS) has been recognized as a noninvasive neurosurgical technique for managing psychiatric disorders that are resistant to treatment. Nonetheless, the full understanding of its effectiveness and safety remains incomplete.

A thorough literature search was conducted across PubMed, Google Scholar, and Cochrane Library (n=2060). After filtering out ineligible and duplicate records, three studies (N=17, average age 36.3 years, mean duration of illness 17.4 years) were selected. A single-arm pre–post meta-analysis was performed, reporting pooled effect estimates as mean differences (MD) or event rates with 95% confidence intervals (CI). In cases where SD of change was not reported, it was calculated using pre- and post-SDs with an assumed correlation coefficient (r = 0.5). The study was conducted using the Comprehensive Meta-Analysis (CMA, Version 3) software. Heterogeneity was analyzed using I² statistics. Sensitivity analyses involved leave-one-out testing.

Obsessive-compulsive symptoms were assessed by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), which shows improvement after MRgFUS therapy (CI=95%, p=0.618, I²=0%), though without definitive statistical confirmation. Depressive symptoms were assessed by the Hamilton Depression Rating Scale (HAM-D), which shows significant improvement (CI=95%, p<0.0001, I²=95.6%) after the procedure; leave-one-out confirmed the effect (I²=0%), whereas serious adverse events (CI=95%, p=0.973, I²=0%) and non-serious adverse events (CI=95%, p=0.438, I²=0%) remained statistically insignificant after the procedure.

MRgFUS shows notable effectiveness in alleviating depressive symptoms, but its effects on OCD symptoms remain uncertain. Also the analysis of safely outcomes (serious or non-serious adverse events) remained insignificant. These results underscore procedure for managing treatment-resistant psychiatric disorders, necessitating further validation through larger, multicenter randomized controlled trials.

Authors/Disclosures
Sanjeet Kumar, Jr., MBBS
PRESENTER
Mr. Kumar has nothing to disclose.
Huzaifa S. Nawaz, MBBS Dr. Nawaz has nothing to disclose.
Hassam A. Khatri, MBBS Dr. Khatri has nothing to disclose.
Rakhshan Zulfiqar, MBBS Miss Zulfiqar has nothing to disclose.
Haniya Shahid, MBBS Dr. Shahid has nothing to disclose.
Javeria Farooq, MBBS Dr. Farooq has nothing to disclose.
Iqra Mustafa Ms. Mustafa has nothing to disclose.
Pardeep Kumar, MBBS Dr. Kumar has nothing to disclose.