Clinical Perspectives on Psychiatric Neurosurgery

Area of Science:

• Neuroscience
• Neurosurgery
• Psychiatry

Background:

• Investigational surgical and neuromodulatory interventions aim to treat psychiatric conditions resistant to conventional therapies.
• Psychiatric neurosurgery has a complex history but is experiencing a resurgence.
• Understanding current perceptions is crucial for advancing the field.

Purpose of the Study:

• To examine current perceptions and predictions regarding psychiatric neurosurgery among practicing functional neurosurgeons.
• To assess the evolving landscape of surgical treatments for psychiatric disorders.

Main Methods:

• A 51-question online survey was distributed to members of the American Society for Stereotactic and Functional Neurosurgery (ASSFN).
• Data were collected and analyzed using descriptive and inferential statistical methods.
• 38 completed surveys were analyzed.

Main Results:

• Half of responders utilize psychiatric neurosurgery, most frequently employing deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD).
• Respondents view psychiatric neurosurgery as more effective and having clearer indications for OCD than for depression.
• A majority support the clinical utility of ablative surgery and consider it a valid alternative to DBS for select patients.

Conclusions:

• This study provides an updated perspective on current practices, perceptions, and predictions in psychiatric neurosurgery.
• Findings inform educational priorities and highlight areas for future surgical innovation.
• Attitudes towards psychiatric neurosurgery are evolving, influencing its future role in treating severe psychiatric disorders.