Deep brain stimulation for psychiatric disorders: where we are now

Area of Science:

• Neurosurgery
• Psychiatry
• Neuroscience

Background:

• Human history shows early attempts at mind alteration through physical means, including Stone Age trephination.
• 20th-century neurosurgical interventions for psychiatric conditions yielded initial results but faced backlash due to indiscriminate application and irreversible side effects.
• Advancements in psychiatric diagnostics, pathophysiology understanding, and biomarkers, alongside the rise of psychotropic medications, diminished interest in invasive procedures.

Purpose of the Study:

• To present a historical overview of psychosurgery.
• To summarize the evolution of deep brain stimulation (DBS) for psychiatric disorders.
• To review current evidence supporting DBS for mental health conditions.

Main Methods:

• Historical review of psychosurgery techniques.
• Summary of deep brain stimulation (DBS) development for psychiatric applications.
• Analysis of existing clinical evidence for DBS in treating psychiatric disorders.

Main Results:

• Despite historical challenges, deep brain stimulation (DBS) is emerging as a viable, reversible surgical option for psychiatric disorders.
• The efficacy of DBS in movement disorders provides a foundation for its application in psychiatric conditions.
• Ongoing research and clinical application are exploring DBS for emotional and behavioral circuitry.

Conclusions:

• Deep brain stimulation (DBS) represents a promising, reversible neurosurgical approach for treatment-refractory psychiatric disorders.
• The historical context of psychosurgery informs the development and ethical considerations of modern DBS applications.
• Further research is crucial to fully establish the safety and efficacy of DBS for various mental health conditions.