Patients with treatment-resistant depression who received magnetic resonance-guided focused ultrasound surgery (MRgFUS) showed improvement in their conditions without showing significant complications for over a year, researchers said here on Tuesday.
Surgical methods, including cranial nerve stimulation and resection, are used to treat these patients. Still, it has not been easy to use these methods due to the following side effects and a long recovery from surgery. According to the Health Insurance Review and Assessment Service, the number of patients with depression rose from 601,152 in 2015 to 796,364 in 2019, a 32.5 percent increase.
The joint research team, led by Professors Kim Chan-hyung and Chang Jin-woo of Severance Hospital and Chang Jin-goo of Myongji Hospital, performed bilateral anterior capsulotomy (BAC) operations on four patients under the guidance of magnetic resonance imaging (MRI).
A bilateral anterior capsulotomy is an operation that removes the brain circuits associated with depression/compulsion.
Patients took an objective depression assessment, the Hamilton Depression Rating Scale (HAM-D), and a subjective test, the Beck Depression Inventory (BDI). They also had neurological, neuropsychological, and MRI assessments for up to 12 months after the procedure.
After 12 months, their HAM-D and BDI score dropped by 83 and 61.2 percent, respectively.
All four patients did not develop physical, neurological, or psychological complications after surgery. No clinically significant decline in cognitive functions was observed in the neuropsychological test performed before and after the surgery.
“So far, 52 percent of patients had experienced temporary side effects such as delirium, and 21 percent had suffered from permanent symptoms such as cerebral hemorrhage, urinary incontinence, and headache after receiving craniotomy for intractable depression,” Professor Kim said.
MRgFUS has no known side effects and does not need to open the skull and cause bleeding or risk of infection, so it has the potential for more use, Kim noted.
The journal Bipolar Disorder has recently published the study under the title of “Bilateral thermal capsulotomy with magnetic resonance-guided focused ultrasound for patients with treatment-resistant depression: A proof-of-concept study.”