Deep brain stimulation of the nucleus accumbens for the treatment of addiction

Müller, Ulf; Voges, Jürgen; Steiner, Johann; Galazky, Imke; Heinze, Hans‐Jochen; Möller, M.; Pisapia, Jared; Halpern, Casey H.; Caplan, Arthur L.; Bogerts, Bernhard; Kuhn, Jens

doi:10.1111/j.1749-6632.2012.06834.x

Cited by 115 publications

(86 citation statements)

References 80 publications

(148 reference statements)

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“…Approximately 80,000 individuals have undergone DBS treatment worldwide, with a reported mortality rate of 0-0.4% (10). The side effects associated with DBS are categorized as acute side effects of surgery and long-term side effects.…”

Section: The Side-effect Of Dbsmentioning

confidence: 99%

“…The first report suggesting that DBS could treat depressive disorder was published in 2005 (9). DBS has been authorized for the treatment of epilepsy and OCD in Europe, and for the treatment of refractory OCD treatment in the USA (10). This approval has increased research and promoted the development of DBS, particularly regarding the mechanisms of vagus nerve stimulation (11).…”

Section: Introductionmentioning

confidence: 99%

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Advanced research on deep brain stimulation in treating mental disorders (Review)

et al. 2017

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Section: The Side-effect Of Dbsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Advanced research on deep brain stimulation in treating mental disorders (Review)

et al. 2017

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“…142 Two of the 5 patients were abstinent for at least 5 years following DBS and the remaining 3 had marked decreases in their alcohol consumption. One patient had a 2-week hypomanic episode that resolved after changes in stimulation settings.…”

Section: Addictionmentioning

confidence: 94%

“…62,63 Medial prefrontal cortex stimulation also appeared effective in animal studies, but no human cases have been reported. 129,142 Neuromodulation of the nucleus accumbens has been shown to be effective and safe in the treatment of refractory addiction in small cohorts of patients. Given the societal burden imposed by addictive disorders, additional work in this area is warranted.…”

Section: Addictionmentioning

confidence: 99%

Deep brain stimulation: a mechanistic and clinical update

Karas

Mikell

Christian

et al. 2013

FOC

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Deep brain stimulation (DBS), the practice of placing electrodes deep into the brain to stimulate subcortical structures with electrical current, has been increasing as a neurosurgical procedure over the past 15 years. Originally a treatment for essential tremor, DBS is now used and under investigation across a wide spectrum of neurological and psychiatric disorders. In addition to applying electrical stimulation for clinical symptomatic relief, the electrodes implanted can also be used to record local electrical activity in the brain, making DBS a useful research tool. Human single-neuron recordings and local field potentials are now often recorded intraoperatively as electrodes are implanted. Thus, the increasing scope of DBS clinical applications is being matched by an increase in investigational use, leading to a rapidly evolving understanding of cortical and subcortical neurocircuitry. In this review, the authors discuss recent innovations in the clinical use of DBS, both in approved indications as well as in indications under investigation. Deep brain stimulation as an investigational tool is also reviewed, paying special attention to evolving models of basal ganglia and cortical function in health and disease. Finally, the authors look to the future across several indications, highlighting gaps in knowledge and possible future directions of DBS treatment.

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“…83 Müller et al has gone further to characterize DBS as actually granting "full autonomy" to the patient. 59 The ethical underpinnings of DBS treatment for obesity will be further challenged in the clinical-trial phase. Several key factors must be clarified prior to enrollment, including trial design, informed consent, and a greater discussion on the concept that DBS treatment would be a threat to patient identity.…”

mentioning

confidence: 99%

Deep brain stimulation for obesity: rationale and approach to trial design

Ho¹,

Sussman²,

Pendharkar³

et al. 2015

FOC

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Obesity is one of the most serious public health concerns in the US. While bariatric surgery has been shown to be successful for treatment of morbid obesity for those who have undergone unsuccessful behavioral modification, its associated risks and rates of relapse are not insignificant. There exists a neurological basis for the binge-like feeding behavior observed in morbid obesity that is believed to be due to dysregulation of the reward circuitry. The authors present a review of the evidence of the neuroanatomical basis for obesity, the potential neural targets for deep brain stimulation (DBS), as well as a rationale for DBS and future trial design. Identification of an appropriate patient population that would most likely benefit from this type of therapy is essential. There are also significant cost and ethical considerations for such a neuromodulatory intervention designed to alter maladaptive behavior. Finally, the authors present a consolidated set of inclusion criteria and study end points that should serve as the basis for any trial of DBS for obesity.

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Deep brain stimulation of the nucleus accumbens for the treatment of addiction

Cited by 115 publications

References 80 publications

Advanced research on deep brain stimulation in treating mental disorders (Review)

Advanced research on deep brain stimulation in treating mental disorders (Review)

Deep brain stimulation: a mechanistic and clinical update

Deep brain stimulation for obesity: rationale and approach to trial design

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