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Recent advances in deep brain stimulation in psychiatric disorders
Anne-Hélène Clair1, William Haynes1,2, Luc Mallet1,3
1Sorbonne University, UPMC Paris 06 University, INSERM, CNRS, Institut du Cerveau et de la Moelle épinière, Paris, France.
F1000Research
|June 16, 2018
Summary
Deep brain stimulation (DBS) shows promise for Obsessive Compulsive Disorder and Tourette Syndrome, improving symptoms and quality of life. However, its efficacy for Major Depression remains unproven, necessitating further clinical trials for psychiatric disorders.
Area of Science:
- Neurosurgery
- Psychiatry
- Neuroscience
Background:
- Deep brain stimulation (DBS) is a neuromodulation technique used for severe, treatment-resistant neuropsychiatric disorders.
- Key targets involve the cortico-striato-thalamo-cortical circuits, influencing symptom severity.
Purpose of the Study:
- To review recent clinical outcomes of DBS in psychiatric disorders.
- To assess the efficacy and ongoing research directions for DBS in conditions like OCD, TS, MDD, anorexia nervosa, and addiction.
Main Methods:
- Review of recent clinical studies and outcomes.
- Analysis of long-term effects, adjuvant therapies, and randomized controlled trials.
Main Results:
- DBS shows encouraging long-term results for Obsessive Compulsive Disorder (OCD) and Gilles de la Tourette Syndrome (TS), improving symptoms and quality of life.
- Adjuvant therapies like cognitive behavioral therapy enhance DBS response in OCD and TS.
- Large randomized studies have not demonstrated DBS efficacy for Major Depressive Disorder (MDD) based on evidence-based criteria.
- Preliminary results for anorexia nervosa and addiction are encouraging.
- No current DBS target meets international criteria for clinical efficacy in psychiatric disorders.
Conclusions:
- DBS remains a promising but investigational treatment for severe neuropsychiatric disorders.
- Further research and clinical trials are essential to establish efficacy and define optimal targets.
- DBS efficacy varies significantly across different psychiatric conditions, with stronger evidence for OCD and TS than MDD.
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