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Approaches to neuromodulation for schizophrenia
Judith M Gault1,2, Rachel Davis2, Nicola G Cascella3
1Department of Neurosurgery, University of Colorado at Denver Anschutz Medical Campus, Aurora, Colorado, USA.
Journal of Neurology, Neurosurgery, and Psychiatry
|December 16, 2017
Summary
Deep brain stimulation (DBS) shows promise for schizophrenia (SZ) treatment by modulating brain circuits. Further research and ethical considerations are crucial for developing DBS therapies for SZ patients.
Area of Science:
- Neuroscience
- Neurosurgery
- Psychiatry
Background:
- Schizophrenia (SZ) presents significant unmet needs, including relapse, persistent psychosis, side effects, and inadequate treatments for negative/cognitive symptoms.
- Deep brain stimulation (DBS) is successful in movement disorders, prompting interest in its application for schizophrenia.
- SZ is increasingly viewed as a circuit disorder, suggesting potential therapeutic targets for neuromodulation.
Purpose of the Study:
- To review the unmet needs in schizophrenia treatment.
- To explore the scientific rationale for deep brain stimulation (DBS) targets in schizophrenia.
- To guide future DBS development for schizophrenia.
Main Methods:
- Literature review of DBS for schizophrenia.
- Analysis of genetic, pharmacological, and neuroimaging evidence implicating circuit neuropathology in SZ.
- Consideration of DBS targets for psychosis, tardive dyskinesia, and negative/cognitive symptoms.
Main Results:
- DBS is a potential intervention for schizophrenia, targeting striatal dysregulation.
- Proposed DBS targets may modulate brain circuits implicated in psychosis.
- Development of neurophysiological biomarkers is needed to refine DBS targeting for SZ.
Conclusions:
- DBS holds potential for treating severe schizophrenia symptoms.
- Ethical considerations, including patient consent and risk-benefit assessment, are paramount for clinical trials.
- Psychiatric patients should have access to neurosurgical advancements like DBS.
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