Clinical Psychiatric Neurosurgery Program at Butler Hospital Publishes Positive Outcomes on MRI-Guided Laser Surgery for Obsessive-Compulsive Disorder

(Providence, RI)  -- New research by Butler Hospital Psychiatric Neurosurgery Program could be life-changing for people suffering from obsessive-compulsive disorder (OCD). The recently published data shows positive results into the use of a new lesion surgery to treat severe OCD.

OCD is a neuropsychiatric illness that causes repeated unwanted thoughts and repetitive behaviors. Some individuals with severe illness do not respond to medication or behavioral therapies. Surgical intervention is one consideration for a subset of those who do not respond to therapeutic options.

 

The research focused on assessing the clinical outcomes and safety profile in 10 patients who underwent this type of surgery, called bilateral ventral capsulotomy, which is carried out using magnetic resonance imaging-guided laser interstitial thermal therapy (LITT). LITT is a minimally invasive ablative technique performed with precise targeting and use of thermography under magnetic resonance guidance. In prior studies, lesions of the ventral anterior limb of the internal capsule using other techniques (e.g. gamma knife) have been effective.

 

Led by Nicole C. McLaughlin, PhD, Neuropsychologist, Butler Hospital, Assistant Professor (Research) at The Warren Alpert Medical School of Brown University, the psychiatric neurosurgery team followed the patients for six months to two years.

 

“This is the largest sample published thus far showing positive outcomes using this new method, LITT, to treat patients with treatment-resistant OCD. We hope that adding a new technique will provide more treatment options for these severely ill patients,” said McLaughlin.

 

McLaughlin added that the results were positive, with seven of the nine patients considered full responders, with a change of ≥35% on the Yale-Brown Obsessive-Compulsive Scale. Two patients showed transient apathy/amotivation after surgery; one patient had a small hemorrhage along the tract where the laser fiber crossed the cerebral cortex, as well as persistent insomnia post-surgery. One individual died after a drug overdose seven months after the surgery, which was not considered related to the surgery.

 

“Overall, LITT ventral capsulotomy was generally well tolerated, with promising evidence of effectiveness in the largest such series to date,” McLaughlin said. “Results were comparable to those after gamma knife ventral capsulotomy, as well as deep brain stimulation."

 

You can read more about the program here (https://www.butler.org/psychiatric-neurosurgery-program).

 

About Butler Hospital

Butler Hospital, a member of Care New England, is the only private, nonprofit psychiatric and substance abuse hospital serving adults, seniors and adolescents in Rhode Island and southeastern New England. Founded in 1844, it was the first hospital in Rhode Island and has earned a reputation as the leading provider of innovative psychiatric treatments in the region. The Major Affiliated Teaching Hospital for Psychiatry and Behavioral Health at The Warren Alpert Medical School of Brown University, Butler is recognized worldwide as a pioneer in conducting cutting-edge research. For more information, visit butler.org.