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Deep brain stimulation for psychiatric disorders.

Brian Harris Kopell1, Benjamin Greenberg, Ali R Rezai

  • 1Center for Neurological Restoration, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|April 21, 2004
PubMed
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Deep brain stimulation (DBS) is a reversible neurosurgical technique offering adjustable treatment for movement disorders and refractory psychiatric conditions. Initial studies show promise for DBS in treating obsessive-compulsive disorder (OCD).

Area of Science:

  • Neurosurgery
  • Psychiatry
  • Neuroscience

Background:

  • Deep brain stimulation (DBS) has transformed movement disorder treatment.
  • DBS is being explored for refractory psychiatric conditions due to its advantages over lesioning.
  • Advantages include reversibility, adjustable stimulation, and suitability for double-blind studies.

Purpose of the Study:

  • To explore the potential of DBS in treating psychiatric disorders.
  • To identify appropriate surgical targets for psychiatric DBS.
  • To review the role of cortico-striato-thalamocortical (CSTC) loops in psychiatric pathophysiology.

Main Methods:

  • Review of functional imaging studies supporting the CSTC loop model.
  • Analysis of psychiatric and cognitive effects from movement disorder DBS.

Related Experiment Videos

  • Examination of published studies on DBS for obsessive-compulsive disorder (OCD).
  • Main Results:

    • CSTC loops are strongly implicated in the pathophysiology of psychiatric symptoms.
    • Functional imaging corroborates the CSTC loop model.
    • DBS can modulate neural systems involved in psychiatric phenomena, with initial OCD studies showing safety.

    Conclusions:

    • DBS is a promising, reversible, and adjustable neuromodulation technique for psychiatric disorders.
    • Targeting CSTC loops is a key strategy for psychiatric DBS.
    • While efficacy data for OCD are still emerging, initial results are encouraging.