Jeffrey Kotas spent years trapped in the prison of his treatment-resistant obsessive-compulsive disorder. Thanks to a combination of focused ultrasound and intense therapy, he’s enjoying newfound freedom.
Two years ago, Jeffrey Kotas’s life was at a standstill. He spent his time holed up at home in Toronto, taking two to four showers each day and spending up to 12 hours in the bathroom to combat what he believed was widespread contamination.
Simple daily activities would trigger his severe obsessive-compulsive disorder (OCD). Some episodes would leave him shaking uncontrollably on the floor for as long as 15 minutes. He also suffered from depression, spending entire days in bed. “It was unbearable,” he says.
But then came some exciting news: Jeffrey found out about a promising new clinical trial at Sunnybrook that could change his life.
A groundbreaking new approach
Thanks to donor investment, Sunnybrook is testing the use of focused ultrasound (FUS), a minimally invasive, scalpel-free form of brain surgery, as a treatment for patients with severe OCD. The procedure uses ultrasound waves to create a tiny lesion on a targeted area of the brain. The idea is that the focused waves alter the brain’s circuitry, quieting the OCD “loop” that leads to symptoms.
When he heard about the procedure, Jeffrey liked that it didn’t involve open surgery and that the recovery time was rapid. He remembers thinking, “This is the perfect thing for me.”
In July 2017, Jeffrey became the first person in North America to participate in the first phase of this potentially life-saving clinical trial at Sunnybrook. “I wanted to be on the cutting edge of science,” he says. “Even if it didn’t work for me, it would for someone else.”
A brave new world
Jeffrey gradually began noticing subtle changes. While on a rare grocery trip, Jeffrey realized that he was not sweating. Before, “it had been excruciatingly painful,” he says. “Now, I wasn’t sweating at all. That was a moment of shock for me.”
Jeffrey is also coping well in the midst of the COVID-19 pandemic, an unprecedented event that made most of the population hyper-sensitive about germs.
Jeffrey’s success in the face of a debilitating disorder is the story of one person’s perseverance and willingness to seek new treatments. It’s also the story of how donor support for Sunnybrook can change lives.
A new way forward for severe mental illness
Focused ultrasound (FUS) has been used for years to treat conditions like essential tremor and uterine fibroids, but this is the first clinical trial in North America to demonstrate the safety of this potential treatment option for OCD.
“We are breaking the cycle,” says Dr. Nir Lipsman, director of the Harquail Centre for Neuromodulation and the study’s principal investigator, of FUS. “It’s a safe procedure in neurosurgical terms, and it can be helpful for some patients who are treatment-resistant.”
Dr. Lipsman says that while it is not a cure-all, and most often must be combined with therapy and medication, FUS has the potential to offer more effective treatments to a greater number of patients. That’s because of the relative ease of the procedure as well as its fast recovery time.
“The goal is to have a safer, more effective way of treating OCD [as opposed to] open neurosurgical approaches,” says
Dr. Lipsman.
For Jeffrey, the combination of FUS and the residential treatment program has been transformative. “I had a lifetime of change in a short span of time,” he says.
Thanks to donor support for this research, the first phase of this study was recently completed and plans for the second phase of testing are underway. Donor funds for FUS research at Sunnybrook have also enabled another North-American first: testing this procedure as a potential treatment for major depression. Results from the first phase of both studies have been published in major medical journals. Read more here.
