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Deep Brain Stimulation for Addictive Disorders-Where Are We Now?
Jason Yuen1,2, Abbas Z Kouzani3, Michael Berk2
1Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
Summary
Deep brain stimulation (DBS) shows promise for treating severe addiction. While research is ongoing, DBS, especially targeting the nucleus accumbens, may offer a last resort for refractory substance use disorders.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- Substance use disorders present a significant global health and economic burden.
- Developing novel therapies for refractory addiction is crucial to mitigate these costs.
- Deep brain stimulation (DBS) is being investigated as a potential treatment for severe addiction.
Approach:
- A comprehensive literature review of preclinical and clinical studies on DBS for addiction was conducted.
- Electronic databases (MEDLINE, EMBASE, Cochrane library) were searched for relevant studies published between 1974 and June 2021.
- Selected articles were analyzed to evaluate DBS' therapeutic potential and mechanisms of action.
Key Points:
- Preclinical studies indicate DBS in targets like the nucleus accumbens (NAc) reduces drug use and seeking behaviors in animals.
- Human studies, primarily case series, predominantly targeted the NAc and reported generally positive outcomes.
- The prefrontal cortex emerged as a promising target for DBS in preclinical research.
Conclusions:
- Deep brain stimulation, particularly targeting the nucleus accumbens, appears to be a viable last-resort option for refractory addiction.
- Further research is needed to develop objective biomarkers for monitoring DBS treatment efficacy.
- Exploring DBS of the prefrontal cortex in human studies is recommended for future therapeutic development.
