Deep brain stimulation of the orbitofrontal projections for the treatment of intermittent explosive disorder.
Intermittent explosive disorder (IED) is characterized by a dysfunction in the greater limbic system leading an individual to experience sudden aggressive behavior with little or no environmental perturbation. This report describes a procedure for the treatment of IED in a 19-year-old woman with a history of IED, having had episodes of severe violent attacks against family, dating to early childhood. Due to the severity and intractability of the illness, deep brain stimulation was performed, targeting the orbitofrontal projections to the hypothalamus. The patient's history and the procedure, management, and rationale are described in detail.
Maley
Jason H
JH
Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
Alvernia
Jorge E
JE
Valle
Edison P
EP
Richardson
Donald
D
D000328:Adult; D000374:Aggression / Q000523:psychology; D046690:Deep Brain Stimulation / Q000379:methods*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000601:surgery / Q000628:therapy*; D005260:Female; D005625:Frontal Lobe / Q000502:physiology*; D006801:Humans; D007031:Hypothalamus / Q000502:physiology*; D020772:Internal Capsule / Q000502:physiology; D008032:Limbic System / Q000601:surgery; D009434:Neural Pathways / Q000502:physiology; D009714:Nucleus Accumbens / Q000502:physiology; D017060:Patient Satisfaction; D011699:Putamen / Q000502:physiology; D011788:Quality of Life / Q000523:psychology; D012686:Septal Nuclei / Q000502:physiology; D016896:Treatment Outcome