Friday, March 30, 2012

Surgery for Psychiatric Disorders

Publication year: 2012
Source:World Neurosurgery
Judy Luigjes, Bart P. de Kwaasteniet, Pelle P. de Koning, Marloes S. Oudijn, Pepijn van den Munckhof, P. Richard Schuurman, Damiaan Denys
Surgery in psychiatric disorders has a long history and has regained momentum in the last few decades with deep brain stimulation (DBS). DBS is an adjustable and reversible neurosurgical intervention using implanted electrodes to deliver controlled electrical pulses to targeted areas of the brain. It holds great promise for therapy-refractory obsessive-compulsive disorder (OCD), several double blind controlled and open trails have been conducted and the response rate is estimated around 54%. Open trials have shown encouraging results with DBS for therapy-refractory depression and case reports have shown potential effects of DBS on addiction. Another promising indication is Tourette's syndrome (TS) where potential efficacy of DBS is shown by several case series and few controlled trials. Further research should focus on optimizing DBS with respect to target location and increasing the number of controlled double blinded trials. Additionally, new indications for DBS and new target options should be explored in preclinical research.






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