Deep brain stimulation for intractable psychiatric disorders.
Deep brain stimulation (DBS) has virtually replaced ablative neurosurgery for use in medication-refractory movement disorders. DBS is now being studied in severe psychiatric conditions, such as treatment-resistant depression (TRD) and intractable obsessive-compulsive disorder (OCD). Effects of DBS have been reported in ∼100 cases of OCD and ∼50 cases of TRD for seven (five common) anatomic targets. Although these published reports differ with respect to study design and methodology, the overall response rate appears to exceed 50% in OCD for some DBS targets. In TRD, >50% of patients responded during acute and long-term bilateral electrical stimulation in a different target. DBS was generally well tolerated in both OCD and TRD, but some unique, target- and stimulation-specific adverse effects were observed (e.g., hypomania). Further research is needed to test the efficacy and safety of DBS in psychiatric disorders, compare targets, and identify predictors of response.
Department of Psychiatry, Friedman Brain Institute of the Mount Sinai School of Medicine, New York, New York 10029, USA. wayne.goodman@mssm.edu
Wayne K
WK
Goodman
Ron L
RL
Alterman
D046690:Deep Brain Stimulation / Q000379:methods* / Q000639:trends*; D003866:Depressive Disorder / Q000628:therapy*; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*