Deep Brain Stimulation in Chronic Posttraumatic Stress Disorder: A Systematic Review

Although high-frequency brain stimulation has demonstrated efficacy in various translational models of posttraumatic stress disorder (PTSD), there is a scarcity of studies investigating deep brain stimulation (DBS) in human PTSD populations. The authors sought to investigate the current state of DBS in the setting of treatment-resistant PTSD.

A systematic search was performed in PubMed, Scopus, and Web of Science Core Collection databases by using keywords related to DBS and PTSD. A secondary search for gray literature was conducted in ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform.

Five articles reporting the effect of DBS on six patients with PTSD were retrieved. Electrodes were implanted bilaterally either in the basolateral amygdala (BLa; N=2) or in contact with the subgenual cingulum and uncinate fasciculus (SGC-UF; N=4). No significant perioperative complications related to BLa or SGC-UF lead implantation were reported in all five studies. BLa patients reported mild neuropsychiatric effects during stimulation. All but one patient had a significant decrease in Clinician-Administered PTSD Scale score, with most reporting a subjective reduction in PTSD symptoms.

Although additional research is needed to assess the safety and efficacy of BLa and SGC-UF DBS, these preliminary findings are encouraging. However, the application of DBS in psychiatric treatment remains controversial and largely experimental. Continued studies with larger samples are essential to establish the efficacy and safety profile of DBS specifically with PTSD patients.