Modern neurosurgical techniques for psychiatric disorders

Area of Science:

• Neurosurgery
• Psychiatry
• Neuroscience

Background:

• Psychosurgery involves invasive techniques for psychiatric diseases resistant to conventional treatments.
• Unlike surgeries for anatomical abnormalities, psychiatric diseases often lack discrete cerebral lesions.
• Identifying optimal surgical targets in mental illness presents significant challenges.

Purpose of the Study:

• To review current psychosurgical modalities and their applications in psychiatric disorders.
• To highlight the role of neuroimaging in identifying therapeutic brain regions.
• To emphasize the need for a multi-nodal network approach and multidisciplinary collaboration.

Main Methods:

• Classification of psychosurgical procedures into lesioning (thermocoagulation, stereotactic radiosurgery, focused ultrasound) and stimulation (deep brain stimulation, cortical stimulation, vagus nerve stimulation).
• Review of psychiatric conditions targeted by psychosurgery, including major depressive disorder, OCD, Tourette syndrome, anorexia nervosa, schizophrenia, and substance use disorder.
• Integration of modern neuroimaging techniques to guide surgical interventions.

Main Results:

• Psychosurgery encompasses diverse lesioning and stimulation techniques.
• Several severe psychiatric disorders are amenable to psychosurgical intervention.
• Neuroimaging advances facilitate the identification of brain regions for symptom control.

Conclusions:

• Psychosurgery offers therapeutic options for treatment-resistant psychiatric disorders.
• A multi-nodal network concept is crucial for understanding and treating these complex conditions.
• Multidisciplinary collaboration among psychiatrists, psychologists, neurologists, and neurosurgeons is essential for advancing psychosurgery through well-designed clinical trials.