title: Surgery for psychiatric disorders.
abstract: Surgery in psychiatric disorders has a long history and has regained momentum in the past few decades with deep brain stimulation (DBS). DBS is an adjustable and reversible neurosurgical intervention using implanted electrodes to deliver controlled electrical pulses to targeted areas of the brain. It holds great promise for therapy-refractory obsessive-compulsive disorder. Several double-blind controlled and open trials have been conducted and the response rate is estimated around 54%. Open trials have shown encouraging results with DBS for therapy-refractory depression and case reports have shown potential effects of DBS on addiction. Another promising indication is Tourette syndrome, where potential efficacy of DBS is shown by several case series and a few controlled trials. Further research should focus on optimizing DBS with respect to target location and increasing the number of controlled double-blinded trials. In addition, new indications for DBS and new target options should be explored in preclinical research.
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Judy
authors.initials: J
authors.lastname: Luigjes
authors.forename: Bart P
authors.initials: BP
authors.lastname: de Kwaasteniet
authors.forename: Pelle P
authors.initials: PP
authors.lastname: de Koning
authors.forename: Marloes S
authors.initials: MS
authors.lastname: Oudijn
authors.forename: Pepijn
authors.initials: P
authors.lastname: van den Munckhof
authors.forename: P Richard
authors.initials: PR
authors.lastname: Schuurman
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
mesh_terms: D046690:Deep Brain Stimulation / Q000379:methods*; D003865:Major Depressive Disorder / Q000523:psychology / Q000601:surgery; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D049672:History, 19th Century; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000601:surgery*; D009493:Neurosurgery / Q000266:history / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000601:surgery; D011612:Psychosurgery / Q000266:history / Q000379:methods*; D019966:Substance-Related Disorders / Q000523:psychology / Q000601:surgery; D005879:Tourette Syndrome / Q000523:psychology / Q000601:surgery; D016896:Treatment Outcome