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Deep brain stimulation for intractable psychiatric disorders.

Wayne K Goodman1, Ron L Alterman

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Deep brain stimulation (DBS) is a promising treatment for severe psychiatric disorders like depression and OCD. While generally safe, further research is needed to optimize efficacy and identify patient responders.

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Area of Science:

  • Neurosurgery
  • Psychiatry
  • Neurology

Background:

  • Deep brain stimulation (DBS) has largely superseded ablative neurosurgery for movement disorders.
  • DBS is increasingly investigated for severe psychiatric conditions, including treatment-resistant depression (TRD) and obsessive-compulsive disorder (OCD).

Purpose of the Study:

  • To review the current evidence for DBS in TRD and OCD.
  • To assess the efficacy, safety, and target variability of DBS in psychiatric populations.

Main Methods:

  • Systematic review of published case reports and studies on DBS for OCD and TRD.
  • Analysis of reported response rates, adverse effects, and anatomical targets.

Main Results:

  • Over 50% response rates observed in OCD for specific DBS targets.
  • More than 50% of TRD patients responded to bilateral electrical stimulation.
  • DBS was generally well-tolerated, with some target-specific adverse events like hypomania.

Conclusions:

  • DBS shows significant potential for treating refractory OCD and TRD.
  • Further research is crucial to refine DBS efficacy, safety, target selection, and identify response predictors in psychiatric disorders.