Benjamin Davidson1,2,3, Clement Hamani1,2,3, Yuexi Huang3,4, Ryan M Jones3,4, Ying Meng1,2,3, Peter Giacobbe2,3,5, Nir Lipsman1,2,3. 1. Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. 2. Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada. 3. Sunnybrook Research Institute, Toronto Canada. 4. Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada. 5. Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada.
Abstract
BACKGROUND: Psychiatric surgery is an important domain of functional neurosurgery and involves deep brain stimulation (DBS) or lesional procedures performed for treatment-resistant psychiatric illness. It has recently become possible to use magnetic-guided focused ultrasound (MRgFUS) to perform bilateral capsulotomy, a lesional technique commonly carried out with surgical radiofrequency ablation or stereotactic radiosurgery. MRgFUS offers several advantages, including improved safety and real-time imaging of the lesions. OBJECTIVE: To describe the clinical and technical aspects of performing bilateral MRgFUS capsulotomy in patients with severe refractory depression and obsessive-compulsive disorder. METHODS: We describe the clinical and technical considerations of performing MRgFUS capsulotomy. Topics discussed include patient selection, headframe application, targeting, sonication strategies, and follow-up procedures. RESULTS: MRgFUS capsulotomy was performed in 16 patients without serious clinical or radiographic adverse events. CONCLUSION: MRgFUS allows for a safe, less invasive technique for performing a well-studied psychiatric surgery procedure-the anterior capsulotomy.
BACKGROUND:Psychiatric surgery is an important domain of functional neurosurgery and involves deep brain stimulation (DBS) or lesional procedures performed for treatment-resistant psychiatric illness. It has recently become possible to use magnetic-guided focused ultrasound (MRgFUS) to perform bilateral capsulotomy, a lesional technique commonly carried out with surgical radiofrequency ablation or stereotactic radiosurgery. MRgFUS offers several advantages, including improved safety and real-time imaging of the lesions. OBJECTIVE: To describe the clinical and technical aspects of performing bilateral MRgFUS capsulotomy in patients with severe refractory depression and obsessive-compulsive disorder. METHODS: We describe the clinical and technical considerations of performing MRgFUS capsulotomy. Topics discussed include patient selection, headframe application, targeting, sonication strategies, and follow-up procedures. RESULTS: MRgFUS capsulotomy was performed in 16 patients without serious clinical or radiographic adverse events. CONCLUSION: MRgFUS allows for a safe, less invasive technique for performing a well-studied psychiatric surgery procedure-the anterior capsulotomy.
Authors: Hongchae Baek; Daniel Lockwood; Emily Jo Mason; Emmanuel Obusez; Matthew Poturalski; Richard Rammo; Sean J Nagel; Stephen E Jones Journal: Front Neurol Date: 2022-05-09 Impact factor: 4.086
Authors: Jason Yuen; Kai J Miller; Bryan T Klassen; Vance T Lehman; Kendall H Lee; Timothy J Kaufmann Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2021-12-20
Authors: Benjamin Davidson; Clement Hamani; Ying Meng; Anusha Baskaran; Sachie Sharma; Agessandro Abrahao; Margaret Anne Richter; Anthony Levitt; Peter Giacobbe; Nir Lipsman; Jennifer S Rabin Journal: Transl Psychiatry Date: 2020-11-11 Impact factor: 6.222