At the ASTRO meeting, researchers reported that 20 patients with longstanding treatment-resistant depression underwent stereotactic radiosurgical capsulotomy, an incision-free procedure that targets a brain circuit involved in mood and obsessive-compulsive behavior. Among 14 patients with suicidal ideation at baseline, 13 had resolution at last follow-up. Mean Beck Depression Inventory scores fell from 32.4 at baseline to 15.5 among 13 patients followed beyond a year, and improvement was visible by three months.
Most patients had tried multiple prior treatments, including electroconvulsive therapy, transcranial magnetic stimulation, or ketamine. Half also had obsessive-compulsive disorder; their Yale-Brown Obsessive Compulsive Scale scores dropped from 30.0 to an average of 17.7 at three months. Investigators found no neurologic deficits, cognitive decline, personality changes, hemorrhage, or infection after treatment.
Lead investigator Mohamed Khattab called the results potentially life-saving but acknowledged the study's limitations: a small sample, single institution, and no sham control. ASTRO expert Markus Bredel agreed the reduction in suicidal ideation is striking but said larger studies are needed before the approach becomes routine care. Both framed the findings as early evidence from a specialized program.
Radiosurgical capsulotomy has been used for decades in psychiatric illness, mainly for severe OCD. The current study builds on a three-patient proof-of-principle trial and was conducted at Vanderbilt University Medical Center.