scholarly journals Deep brain stimulation for psychiatric disorders: where we are now

2015 ◽  
Vol 38 (6) ◽  
pp. E2 ◽  
Author(s):  
Daniel R. Cleary ◽  
Alp Ozpinar ◽  
Ahmed M. Raslan ◽  
Andrew L. Ko
Keyword(s):  
Deep Brain Stimulation ◽  
Psychiatric Disorders ◽  
Brain Stimulation ◽  
Historical Record ◽  
Psychiatric Disease ◽  
Current Application ◽  
Organic Brain Disease ◽  
Fossil Records ◽  
The Mind ◽  
Deep Brain

Fossil records showing trephination in the Stone Age provide evidence that humans have sought to influence the mind through physical means since before the historical record. Attempts to treat psychiatric disease via neurosurgical means in the 20th century provided some intriguing initial results. However, the indiscriminate application of these treatments, lack of rigorous evaluation of the results, and the side effects of ablative, irreversible procedures resulted in a backlash against brain surgery for psychiatric disorders that continues to this day. With the advent of psychotropic medications, interest in invasive procedures for organic brain disease waned. Diagnosis and classification of psychiatric diseases has improved, due to a better understanding of psychiatric patho-physiology and the development of disease and treatment biomarkers. Meanwhile, a significant percentage of patients remain refractory to multiple modes of treatment, and psychiatric disease remains the number one cause of disability in the world. These data, along with the safe and efficacious application of deep brain stimulation (DBS) for movement disorders, in principle a reversible process, is rekindling interest in the surgical treatment of psychiatric disorders with stimulation of deep brain sites involved in emotional and behavioral circuitry. This review presents a brief history of psychosurgery and summarizes the development of DBS for psychiatric disease, reviewing the available evidence for the current application of DBS for disorders of the mind.

scholarly journals Charting the road forward in psychiatric neurosurgery: proceedings of the 2016 American Society for Stereotactic and Functional Neurosurgery workshop on neuromodulation for psychiatric disorders

2018 ◽  
Vol 89 (8) ◽  
pp. 886-896 ◽  
Author(s):  
Ausaf A Bari ◽  
Charles B Mikell ◽  
Aviva Abosch ◽  
Sharona Ben-Haim ◽  
Robert J Buchanan ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Psychiatric Disorders ◽  
Brain Stimulation ◽  
Clinical Trial Design ◽  
Psychiatric Disease ◽  
Functional Neurosurgery ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
American Society ◽  
Deep Brain

ObjectiveRefractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive–compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016.DesignHere we summarise the proceedings of the workshop. Participants discussed a number of issues of importance to the community. First, we discussed how to interpret results from the recent pivotal trials of DBS for OCD and depression. We then reviewed what can be learnt from lesions and closed-loop neurostimulation. Subsequently, representatives from the National Institutes of Health, the Food and Drug Administration and industry discussed their views on neuromodulation for psychiatric disorders. In particular, these third parties discussed their criteria for moving forward with new trials. Finally, we discussed the best way of confirming safety and efficacy of these therapies, including registries and clinical trial design. We close by discussing next steps in the journey to new neuromodulatory therapies for these devastating illnesses.ConclusionInterest and motivation remain strong for deep brain stimulation for psychiatric disease. Progress will require coordinated efforts by all stakeholders.

scholarly journals Special Issue: Trends in Clinical Deep Brain Stimulation

2021 ◽  
Vol 10 (2) ◽  
pp. 178
Author(s):  
Marcus L. F. Janssen ◽  
Yasin Temel
Keyword(s):  
Deep Brain Stimulation ◽  
Psychiatric Disorders ◽  
Brain Stimulation ◽  
Special Issue ◽  
Deep Brain

Deep brain stimulation (DBS) has been successfully applied in several neurological and psychiatric disorders [...]

Neuroimaging Deep Brain Stimulation in Psychiatric Disorders

2012 ◽  
pp. 225-239 ◽  
Author(s):  
Martijn Figee ◽  
Pepijn van den Munckhof ◽  
Rick Schuurman ◽  
Damiaan Denys
Keyword(s):  
Deep Brain Stimulation ◽  
Psychiatric Disorders ◽  
Brain Stimulation ◽  
Deep Brain

Neuroethics

2021 ◽  
pp. 405-420
Author(s):  
Georg Northoff
Keyword(s):  
Deep Brain Stimulation ◽  
Psychiatric Disorders ◽  
Brain Stimulation ◽  
Empirical Data ◽  
Moral Agency ◽  
Ethical Issues ◽  
Spatio Temporal ◽  
The Brain ◽  
Deep Brain

Neuroethics, located at the interface of conceptual and empirical dimensions, carries major implications for psychiatry, such as the neuroscientific basis of ethical concepts as moral agency. Drawing on data in neuroscience, this chapter highlights issues central to psychiatric ethics. First, it addresses a reductionistic model of the brain, often conceived as purely neuronal, and then it discusses empirical data suggesting that the brain’s activity is strongly aligned to its respective social (e.g., relation to others) and ecological (e.g., relation to the environment and nature) contexts; this implies a relational rather than reductionist model. Second, it suggests that self (e.g., the experience or sense of a self) and personhood (e.g., the person as existent independent of experience) must also be understood in such a social and ecological and, therefore, relational and spatio-temporal sense. Ethical concepts like agency, therefore, cannot be limited solely to the person and brain, but must rather be understood in a relational and neuro-ecological/social way. Third, it discusses deep brain stimulation as a treatment that promotes enhancement. In sum, this chapter presents findings in neuroscience that carry major implications for our view of brain, mental features, psychiatric disorders, and ethical issues like agency, responsibility, and enhancement.

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