A systematic review of psychiatric indications for deep brain stimulation, with focus on major depressive and obsessive-compulsive disorder

Naesström, Matilda; Blomstedt, Patric; Bodlund, Owe

doi:10.3109/08039488.2016.1162846

Cited by 56 publications

(42 citation statements)

References 63 publications

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“…Experimental neuromodulation via brain electrodes was first tried in patients with psychiatric disorders during the 1950s (Heath, Russell, Monroe, & Mickle, 1955). Since then, more than 120,000 neurological patients have been treated with DBS, whereas only an estimated 500 psychiatric patients received DBS (Benabid, 2003;Naesstr€ om, Blomstedt, & Bodlund, 2016). This might be explained in part by the historically rooted taboo on neurosurgical interventions for psychiatry, but also by the heterogenic symptomatology and complex neuroanatomy of psychiatric disorders.…”

Section: Introductionmentioning

confidence: 99%

The application of deep brain stimulation in the treatment of psychiatric disorders

Graat

Figee

Denys

2017

International Review of Psychiatry

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Deep brain stimulation (DBS) is a last-resort treatment for neurological and psychiatric disorders that are refractory to standard treatment. Over the last decades, the progress of DBS in psychiatry has been slower than in neurology, in part owing to the heterogenic symptomatology and complex neuroanatomy of psychiatric disorders. However, for obsessive-compulsive disorder (OCD) DBS is now an accepted treatment. This study first reviews clinical outcomes and mechanisms of DBS for OCD, and then discusses these results in an overview of current and future psychiatric applications, including DBS for mood disorders, Tourette's syndrome, addiction, anorexia nervosa, autism, schizophrenia, and anxiety disorders. In addition, it will focus on novel techniques that may enhance the application of DBS in psychiatry.ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

The application of deep brain stimulation in the treatment of psychiatric disorders

Graat

Figee

Denys

2017

International Review of Psychiatry

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“…However, these side effects are reversible and can be removed changing the stimulation parameters or turning off the neuropacemaker. The stimulation does not seem to result in any residual physiological changes when the treatment is discontinued [6].…”

Section: Deep Brain Stimulationmentioning

confidence: 99%

“…A burr hole is made on each side of the midline for the implantation of two electrodes (about 1.3 mm in diameter with several contacts at their distal end) and an extension cable is tunneled under the skin, connecting the electrodes with a neuropacemaker placed below the clavicle in a subcutaneous pocket. The hospitalization duration after surgery depends on time needed for programming the device, but usually patients are discharged within 3-5 days [6].…”

Section: Deep Brain Stimulationmentioning

confidence: 99%

Neuromodulation in Psychiatric disorders: recent findings and clinical implications

Andrade¹,

Mota²,

Ferreira³

et al. 2017

IJCNMH

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The potential therapeutic value of electricity to treat neuropsychiatric disorders has been known for a long time. However, it is only recently that it has been successfully applied to these clinical conditions. Two of the most promising neuromodulation techniques are the deep brain stimulation (DBS) and the transcranial magnetic stimulation (TMS). DBS uses a high-frequency stimulation that causes a "reversible lesion" and is increasingly becoming an alternative for lesional surgery for its better balance between efficacy, tolerability and safety, and has consistently been shown to improve depressive and obsessive symptoms. TMS is a non-invasive and safe approach that has been approved for the treatment of major depressive disorder and for auditory-verbal hallucinations in schizophrenia and is being studied in several other psychiatric disorders, such as obsessive-compulsive disorder, eating disorders and negative symptoms of schizophrenia.In the current paper, we will review recent evidence of these two neuromodulation techniques, its main psychiatric indications and present two brief case reports to further illustrate its clinical applicability.

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“…1,3,20,27 Additionally, minimally invasive ablative procedures, such as stereotactic radiosurgery, retain a prominent role is affording patients relief from the symptoms of intractable OCD. A study of 5 patients who underwent bilateral anterior capsulotomy with Gamma Knife radiosurgery for refractory OCD revealed that 4 patients demonstrated marked clinical improvement, and the remaining patient demonstrated mild clinical improvement, as measured by reductions in Yale-Brown Obsessive-Compulsive Scale scores.…”

Section: Ethical Considerations and The Future Of Psychosurgerymentioning

confidence: 99%

Psychosurgery, ethics, and media: a history of Walter Freeman and the lobotomy

Caruso¹,

Sheehan

2017

Neurosurgical Focus

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At the peak of his career, Walter J. Freeman II was a celebrated physician and scientist. He served as the first chairman of the Department of Neurology at George Washington University and was a tireless advocate of surgical treatment for mental illness. His eccentric appearance, engaging personality during interviews, and theatrical demonstrations of his surgical techniques gained him substantial popularity with local and national media, and he performed more than 3000 prefrontal and transorbital lobotomies between 1930 and 1960. However, poor patient outcomes, unfavorable portrayals of the lobotomy in literature and film, and increased regulatory scrutiny contributed to the lobotomy’s decline in popularity. The development of antipsychotic medications eventually relegated the lobotomy to rare circumstances, and Freeman’s reputation deteriorated. Today, despite significant advancements in technique, oversight, and ethical scrutiny, neurosurgical treatment of mental illness still carries a degree of social stigma.This review presents a historical account of Walter Freeman’s life and career, and the popularization of the lobotomy in the US. Additionally, the authors pay special attention to the influence of popular literature and film on the public’s perception of psychosurgery. Aided by an understanding of this pivotal period in medical history, neurosurgeons are poised to confront the ethical and sociological questions facing psychosurgery as it continues to evolve.

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A systematic review of psychiatric indications for deep brain stimulation, with focus on major depressive and obsessive-compulsive disorder

Cited by 56 publications

References 63 publications

The application of deep brain stimulation in the treatment of psychiatric disorders

The application of deep brain stimulation in the treatment of psychiatric disorders

Neuromodulation in Psychiatric disorders: recent findings and clinical implications

Psychosurgery, ethics, and media: a history of Walter Freeman and the lobotomy

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