title: Posttraumatic Stress Disorder: Perspectives for the Use of Deep Brain Stimulation.
abstract: OBJECTIVE
  Deep Brain Stimulation (DBS) has been either approved or is currently under investigation for a number of psychiatric disorders.
  
  
  METHODS
  We review clinical and preclinical concepts as well as the neurocircuitry that may be of relevance for the implementation of DBS in posttraumatic stress disorder (PTSD).
  
  
  RESULTS
  PTSD is a chronic and debilitating illness associated with dysfunction in well-established neural circuits, including the amygdala and prefrontal cortex. Although most patients often improve with medications and/or psychotherapy, approximately 20-30% are considered to be refractory to conventional treatments. In other psychiatric disorders, DBS has been investigated in treatment-refractory patients. To date, preclinical work suggests that stimulation at high frequency delivered at particular timeframes to different targets, including the amygdala, ventral striatum, hippocampus, and prefrontal cortex may improve fear extinction and anxiety-like behavior in rodents. In the only clinical report published so far, a patient implanted with electrodes in the amygdala has shown striking improvements in PTSD symptoms.
  
  
  CONCLUSIONS
  Neuroimaging, preclinical, and preliminary clinical data suggest that the use of DBS for the treatment of PTSD may be practical but the field requires further investigation.
authors.affiliation: Behavioural Neurobiology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Roman
authors.initials: R
authors.lastname: Reznikov
authors.affiliation: Behavioural Neurobiology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.|Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Clement
authors.initials: C
authors.lastname: Hamani
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000379:methods*; D006801:Humans; D013313:Stress Disorders, Post-Traumatic / Q000000981:diagnostic imaging / Q000628:therapy*
keywords: Amygdala; anxiety; deep brain stimulation; fear extinction; posttraumatic stress disorder; prefrontal cortex