First clinical use of epidural stimulation in catatonia

Stip, Emmanuel; Lespérance, Paul; Farmer, Olivier; Fournier‐Gosselin, Marie‐Pierre

doi:10.1016/j.brs.2017.03.006

Cited by 7 publications

(11 citation statements)

References 8 publications

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“…Further analysis of BFCRS scores was performed for six patients who received rTMS and 12 patients who received tDCS. We used 15 as the post-treatment score for one case ( 55 ) because some studies reported BFCRS scores of <15 during rTMS. The paired-sample t -tests showed significant symptom improvement after rTMS ( t = 4.489, p = 0.006).…”

Section: Resultsmentioning

confidence: 99%

“…Among the 12 rTMS case reports, 11 ( 46 , 47 , 49 – 57 ) showed a low risk of bias, and one ( 48 ) showed a moderate risk of bias. The overall scores for the rTMS case reports were as follows: 100% for two studies ( 46 , 53 ), 87.5% for five studies ( 49 , 52 , 54 , 56 , 57 ), 75% for four studies ( 47 , 50 , 51 , 55 ), and 50% for one study ( 48 ). Of all, eight ( 47 – 51 , 54 , 55 , 57 ) of the 12 case reports did not describe adverse events (harms) or unanticipated events.…”

Section: Resultsmentioning

confidence: 99%

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Non-invasive brain stimulation for treating catatonia: a systematic review

et al. 2023

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BackgroundNon-invasive brain stimulation (NIBS) techniques offer new therapeutic options for modifying pathological neuroplasticity and have been proven to be beneficial in the treatment of neuropsychiatric disorders.ObjectiveThis study aimed to investigate the role of NIBS in treating catatonia.Materials and methodsWe conducted a systematic search to identify meta-analyses or systematic reviews on electroconvulsive therapy (ECT) and studies on the effects of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on patients with catatonia from the PubMed, Web of Science, Embase, China National Knowledge Internet, Wanfang, and China Science and Technology Journal databases from inception until 31 July 2022. The methodological quality of the included studies was assessed with the AMSTAR2 or Joanna Briggs Institute Critical Appraisal tools. Paired t-tests and Wilcoxon signed-rank tests were used to compare changes in catatonia symptom scores after rTMS or tDCS.ResultsA total of 13 systematic reviews and one meta-analysis on ECT, two systematic reviews and 12 case reports on rTMS, and seven studies of 14 cases applying tDCS were identified. Systematic reviews of ECT consistently described improvement in catatonia symptoms across catatonia types and patient age groups. After treatment with rTMS (t = 4.489, p = 0.006) and tDCS (z = −3.065, p = 0.002), patients exhibited significant improvement.ConclusionECT, rTMS, and tDCS were effective in treating catatonia. Early intervention with NIBS techniques may help improve catatonia symptoms in patients with schizophrenia. It may be advantageous to use rTMS or tDCS to maintain this improvement. NIBS techniques may thus represent a promising treatment for catatonia, but additional high-quality randomized controlled trials are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Non-invasive brain stimulation for treating catatonia: a systematic review

et al. 2023

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“…This technique allows for a total of 6560 potential combinations of stimulations in each session with 4 electrodes placed in each hemisphere. 21 The patient has not fully recovered from psychosis since epidural stimulation implantation but has remained stable as an outpatient at year-8 follow-up, without the need for inpatient admission to forensic services. The patient can be evaluated after implantation in the prestimulation and poststimulation periods.…”

Section: Ablative Versus Nonablative Methods and Clinical Examplesmentioning

confidence: 96%

“…The other example illustrates the use of epidural stimulation, a more recently developed nonablative technique, to treat a case of refractory catatonic schizophrenia at the University of Montreal. 21 The device was applied to a 43-year-old forensic male patient with a 20-year history of illness who only responded to electroconvulsive therapy (ECT). After 560 ECT sessions followed by a 2-year period of weekly and subsequently monthly sessions of repetitive transcranial magnetic stimulation, an epidural stimulator was implanted under neuro-navigation guidance (Figure 1, right picture).…”

Section: Ablative Versus Nonablative Methods and Clinical Examplesmentioning

confidence: 99%

“…After 2 years on rTMS without ECT, frontal lobes epidural stimulation, to improve autonomy and recovery was suggested. Two electrodes with 4 contact paddles implanted on the dura mater over the DLPFC through small craniotomies and under neuro-navigation (Stip et al 21 ). A persistent improvement in catatonia was objectively documented.…”

Section: Current Neurosurgical Techniques To Treat Mental Health Cond...mentioning

confidence: 99%

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Happy Birthday “One Flew Over the Cuckoo's Nest”: A Momentous Tale in the Quest for an Effective and Ethical Approach to Psychosurgery

et al. 2023

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The anniversary of the publication of 'One Flew Over the Cuckoo's Nest' by Ken Kesey offers an opportunity for reflection on the use of neurosurgery in psychiatry. We used a narrative, historical and dialectical method to deliver an account of the controversial subject. A balanced representation of the negative and positive aspects, acknowledging some of the questionable ethical practices while describing well-reasoned applications is provided. It includes neurosurgeons, psychiatrists who have embraced these procedures with unwarranted enthusiasm and those who have opposed. Neurosurgical techniques for the treatment of severe mental disorders have evolved from rudimentary procedures which were used to ‘correct' unwanted behaviours associated with a wide range of severe mental disorders to more refined and selective approaches used as a last resort to treat specific mental health conditions. In the absence of specific aetiological models to guide ablative surgical targets, non-ablative, stimulatory techniques have more recently been developed to allow reversibility when surgical treatment fails to obtain a sizeable improvement in quality of life. The subject is concretely illustrated by two eloquent clinical images: one on a series of brain computed tomography scans carried out on a Canadian population of subjects, who underwent leukotomy decades ago, and the other more contemporary on an implantation surgery to epidural stimulation. Alongside technical advances in psychosurgery, a regulatory framework has gradually developed to ensure vigilance in the appropriateness of patients’ selection. Nevertheless, harmonisation of protocols around the world is necessary to ensure consistency in obtaining and maintaining the highest possible ethical standards for the benefit of patients. If the neurosciences promise today, in their new, better framed, and reversible applications, to provide answers to unmet therapeutic needs, we still must remain attentive to drifts linked the introduction of intrusive technologies for purposes of domination or behaviour modification that would impede our individual freedom.

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Invasive cortical stimulation

Ogbuji

Kopell

2021

International Review of Neurobiology

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First clinical use of epidural stimulation in catatonia

Cited by 7 publications

References 8 publications

Non-invasive brain stimulation for treating catatonia: a systematic review

Non-invasive brain stimulation for treating catatonia: a systematic review

Happy Birthday “One Flew Over the Cuckoo's Nest”: A Momentous Tale in the Quest for an Effective and Ethical Approach to Psychosurgery

Invasive cortical stimulation

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