Nucleus Accumbens Deep Brain Stimulation for Alcohol Addiction – Safety and Clinical Long-term Results of a Pilot Trial

Müller, Ulf; Sturm, Volker; Voges, J.; Heinze, Hans‐Jochen; Galazky, Imke; Büntjen, Lars; Heldmann, Marcus; Frodl, Thomas; Steiner, Johann; Bogerts, Bernhard

doi:10.1055/s-0042-104507

Cited by 84 publications

(73 citation statements)

References 26 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Three studies investigated the effects of DBS on alcohol use disorder, applying active stimulation to the nucleus accumbens, showing a decrease in alcohol consumption or craving levels across studies (Table ).…”

Section: Resultsmentioning

confidence: 99%

A review of brain stimulation methods to treat substance use disorders

2018

View full text Add to dashboard Cite

Background Substance use disorders (SUDs) are a leading cause of disability worldwide. While several pharmacological and behavioral treatments for SUDs are available, these may not be effective for all patients. Recent studies using non-invasive neuromodulation techniques including Repetitive Transcranial Magnetic Stimulation (rTMS), Transcranial Direct Current Stimulation (tDCS), and Deep Brain Stimulation (DBS) have shown promise for SUD treatment. Objective Multiple studies were evaluated investigating the therapeutic potential of non-invasive brain stimulation techniques in treatment of SUDs. Method Through literature searches (eg, PubMed, Google Scholar), 60 studies (2000–2017) were identified examining the effect of rTMS, tDCS, or DBS on cravings and consumption of SUDs, including tobacco, alcohol, cannabis, opioids, and stimulants. Results rTMS and tDCS demonstrated decreases in drug craving and consumption, while early studies with DBS suggest similar results. Results are most encouraging when stimulation is targeted to the Dorsolateral Prefrontal Cortex (DLPFC). Conclusions Short-term treatment with rTMS and tDCS may have beneficial effects on drug craving and consumption. Future studies should focus on extending therapeutic benefits by increasing stimulation frequency and duration of treatment. Scientific Significance The utility of these methods in SUD treatment and prevention are unclear, and warrants further study using randomized, controlled designs.

show abstract

Section: Resultsmentioning

confidence: 99%

A review of brain stimulation methods to treat substance use disorders

2018

View full text Add to dashboard Cite

show abstract

“…DBS for treating OCD has been performed in the anterior limb of the internal capsule (Goodman et al , ), the bed nucleus of the stria terminalis (Nuttin et al , ), and the STN (Chabardès et al , ; Fig C) and the NAcc (Huff et al , ; Fig A). The NAcc has also been used to treat different forms of addiction (Müller et al , ). Tourette's syndrome has been treated with DBS in the NAcc (Kuhn et al , ), globus pallidus internus (Akbarian‐Tefaghi et al , ; Fig B), and the ventral anterior thalamus (Voa; Huys et al , ; Fig D).…”

Section: Current and Future Developmentsmentioning

confidence: 99%

Cellular, molecular, and clinical mechanisms of action of deep brain stimulation—a systematic review on established indications and outlook on future developments

et al. 2019

View full text Add to dashboard Cite

Deep brain stimulation ( DBS ) has been successfully used to treat movement disorders, such as Parkinson's disease, for more than 25 years and heralded the advent of electrical neuromodulation to treat diseases with dysregulated neuronal circuits. DBS is now superseding ablative techniques, such as stereotactic radiofrequency lesions. While serendipity has played a role in developing DBS as a therapy, research during the past two decades has shown that electrical neuromodulation is far more than a functional lesion that can be switched on and off. This understanding broadens the field to enable new types of stimulation, clinical indications, and research. This review highlights the complex effects of DBS from the single cell to the neuronal network. Specifically, we examine the electrical, cellular, molecular, and neurochemical mechanisms of DBS as applied to Parkinson's disease and other emerging applications.

show abstract

“…23,47 A total of 5 patients included in this study were considered severely addicted to alcohol and on average consumed at least 200 g of ethanol per day for more than 10 years, and previous detoxifications, inpatient programs of at least 6 months, and pharmaceutical interventions (acamprosate and/or naltrexone) had all failed. 23,46,67 After receiving bilateral NAc DBS, the patient in case 1 became completely abstinent without any cravings or psychological side effects, and remained abstinent 8 years after initiation of treatment. The patient in case 2 experienced a marked reduction in alcohol-related cues and cravings, and on the last long-term follow-up evaluation had been abstinent for 6 years since initiation of treatment.…”

Section: Human Studiesmentioning

confidence: 99%

“…However, it is difficult to identify with certainty what was the cause of death in these patients. 23,24,46 Challenges and Future Directions…”

Section: Human Studiesmentioning

confidence: 99%

The nucleus accumbens and alcoholism: a target for deep brain stimulation

Ho¹,

Salib

Pendharkar³

et al. 2018

Neurosurgical Focus

View full text Add to dashboard Cite

Alcohol use disorder (AUD) is a difficult to treat condition with a significant global public health and cost burden. The nucleus accumbens (NAc) has been implicated in AUD and identified as an ideal target for deep brain stimulation (DBS). There are promising preclinical animal studies of DBS for alcohol consumption as well as some initial human clinical studies that have shown some promise at reducing alcohol-related cravings and, in some instances, achieving long-term abstinence. In this review, the authors discuss the evidence and concepts supporting the role of the NAc in AUD, summarize the findings from published NAc DBS studies in animal models and humans, and consider the challenges and propose future directions for neuromodulation of the NAc for the treatment of AUD.

show abstract

Nucleus Accumbens Deep Brain Stimulation for Alcohol Addiction – Safety and Clinical Long-term Results of a Pilot Trial

Cited by 84 publications

References 26 publications

A review of brain stimulation methods to treat substance use disorders

A review of brain stimulation methods to treat substance use disorders

Cellular, molecular, and clinical mechanisms of action of deep brain stimulation—a systematic review on established indications and outlook on future developments

The nucleus accumbens and alcoholism: a target for deep brain stimulation

Contact Info

Product

Resources

About