Oscillatory local field potentials of the nucleus accumbens and the anterior limb of the internal capsule in heroin addicts

Ge, Shunnan; Geng, Xin; Wang, Xuelian; Li, Nan; Chen, Lei; Zhang, Xinjing; Huang, Yongzhi; Li, Yang; Chen, Yukun; Wang, Shouyan; Gao, Guodong

doi:10.1016/j.clinph.2018.03.008

Cited by 21 publications

(19 citation statements)

References 65 publications

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“…The first patient was lost because of relocation due to a new job, whereas the second and third ones died from alcohol-related causes; 18 the fourth patient died from heroin overdose, even after increasing readjustments in the DBS parameters for relapse correction and difficult control of hypomania; 19 and the fifth patient was lost to follow-up after three months of DBS due to unknown causes. 23 Regarding the results obtained, 48% of the patients were abstinent, 16,17,20,21,[23][24][25] and the others had relapses (52%), but for shorter periods and less frequently than before the surgical treatment. Among the relapsed patients, only one had a desire for the drug, 19 whereas the others reported lack of desire.…”

Section: Study Characteristicsmentioning

confidence: 96%

“…Some studies have stipulated a time interval between implantation and activation of electrode stimulation. In 33% of the studies included, the activation took place after one week; 16,20,21 in 25%, after two weeks; 19,23,24 and, in most of them (42%), DBS was activated on the same day of surgery. 14,15,17,18,22,25 The DBS parameters were individualized according to the patient, with the frequency ranging from 130 Hz to 185 Hz, with a predominance of 130 Hz, the pulse width ranging from 90 µsec to 275 µsec, with a predominance of 90 µsec, and the amplitude ranging from 1 V to 6 V, with a predominance of the the 2.5-4.5 V interval.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…15,[17][18][19]23,24 However, DBS is a treatment susceptible to adverse effects, present in 70% of the patients, although most of them are transient and easily corrected by changing the stimulation parameters. The main immediate side effects reported were: transient hypomania, 15,17,18,20,23,24 sensation of warmth, 23 excessive sweating, decreased libido, 22 mild mental confusion, urinary incontinence, 16 transient obsessive traits, 25 transient weight gain, 22 insomnia, anxiety, dizziness, and speech disorders. 23,24 The immediate effect that was considered the most severe was convulsive seizure, but the patient had already had them before surgery.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The main immediate side effects reported were: transient hypomania, 15,17,18,20,23,24 sensation of warmth, 23 excessive sweating, decreased libido, 22 mild mental confusion, urinary incontinence, 16 transient obsessive traits, 25 transient weight gain, 22 insomnia, anxiety, dizziness, and speech disorders. 23,24 The immediate effect that was considered the most severe was convulsive seizure, but the patient had already had them before surgery. 14 The major long-term symptoms were weight gain, 16 hypomania, 19 and a slight decline in memory.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Neurosurgical Treatment for Drug Addiction: Systematic Review

Santos

Curti

Silva

2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Substance-related disorders are psychiatric conditions that have a worldwide impact. Their multifactorial cycle has been treated pharmacologically and with therapeutic support. However, high refractoriness rates and difficulty to control relapses are among the pitfalls associated with these disorders. Thus, recent studies have shown that deep brain stimulation (DBS) is a promising treatment, with a direct intervention in the neurocircuitry of addiction. The results of the present systematic review of the use of DBS for the treatment of drug addiction show that this surgical procedure can reduce the desire for the drug, and, in some cases, establish abstinence, improve psychiatric symptoms related to mood and quality of life, and reintroduce the patient into the social and family environments. Nevertheless, this approach is still limited to the academic realm, based mainly on case reports, with ethics and therapeutic protocols still to be defined. Further in-depth scientific investigations are required to recommend its clinical application.

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Section: Study Characteristicsmentioning

confidence: 96%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Neurosurgical Treatment for Drug Addiction: Systematic Review

Santos

Curti

Silva

2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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“…Anterior capsulotomy has also been used in an effort to treat patients with refractory mental disorders, such as OCD, depression, and anorexia. Ablative surgery targeting the anterior limb of the internal capsule (ALIC), especially the region containing superolateral branches of the medial forebrain bundle (MFB), may be an effective treatment for drug addiction [19]. The MFB consists of dopaminergic connections between the ventral tegmental area and forebrain limbic structures.…”

Section: Introductionmentioning

confidence: 99%

Deep Brain Stimulation of Nucleus Accumbens with Anterior Capsulotomy for Drug Addiction: A Case Report

Zhu

Zhang

Wang

et al. 2020

Stereotact Funct Neurosurg

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Background: Drug addiction is one of the most prevalent and costly health problems worldwide. Over the past decade, deep brain stimulation (DBS) has increasingly been used for the treatment of drug addiction. Simultaneous DBS of nucleus accumbens (NAc) and the anterior limb of the internal capsule (ALIC) has successfully been used for preventing heroin relapse. However, the excessive energy consumption speeds up battery depletion, which puts a burden on patients. By comparison, anterior capsulotomy is usually more convenient for patients and its clinical efficacy is similar to that of ALIC DBS. Accordingly, NAc DBS combined with anterior capsulotomy may also be an effective, yet more convenient, intervention for drug addiction and relapse prevention. Case Description: The patient was a 28-year-old man with a polysubstance use disorder (bucinnazine, morphine, and hypnotics) for 13 years. After bilateral NAc DBS combined with bilateral anterior capsulotomy, his craving for the three drugs decreased markedly, and he remained abstinent throughout the follow-up period of approximately 1-year. Moreover, psychiatric and neuropsychological assessments showed significant improvements in depression, anxiety, sleep, quality of life, and most aspects of cognitive functioning. His overall health status was also improved. Conclusions: NAc DBS combined with anterior capsulotomy is a promising surgical treatment for drug addiction.

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A protocol of a systematic review on deep brain stimulation surgery and its efficacy in addressing substance abuse addiction

Dimech

Ranjan

2023

Health Science Reports

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Background: Pharmacotherapy and psychotherapeutic approaches are still the mainstay first line of treatment for substance use disorder. However, the path to rehabilitation and cessation of dependence often proves uncertain and laborious, with risks of relapse being considerable despite exposure to current therapeutic modalities. For cases of treatmentrefractory addiction, deep brain stimulation (DBS) interventions can prove a more effective long term therapeutic solution for the patient. Objectives: The aim of the study will be to systematically assess whether attempts at correcting substance use disorder via DBS neurosurgical interventions have been successful in inducing remission or ameliorating relapse rates. Methods: The current study will analyze available literature from database inception up to 15th April 2023, reviewing all publications documenting results achieved with human patients undergoing DBS for substance use disorder in PubMed, Ovid, Cochrane, and Web of Science. The electronic database search will exclude animal studies in the field and focus solely on the application of DBS for the purposes of addressing addiction disorders. Results:The expectation is for a reduced number of trial results to have been reported, namely due to the relatively recent application of DBS to address severe addiction. Nonetheless, numbers should be in sufficient amount to inform about the efficacy of the intervention. Conclusion:This study will attempt to demonstrate the viability of DBS as a solution for tackling treatment-refractory substance use disorder, proposing it as a valid therapeutic option that can deliver robust results and help combat an expanding societal plague that is drug dependence.

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Oscillatory local field potentials of the nucleus accumbens and the anterior limb of the internal capsule in heroin addicts

Cited by 21 publications

References 65 publications

Neurosurgical Treatment for Drug Addiction: Systematic Review

Neurosurgical Treatment for Drug Addiction: Systematic Review

Deep Brain Stimulation of Nucleus Accumbens with Anterior Capsulotomy for Drug Addiction: A Case Report

A protocol of a systematic review on deep brain stimulation surgery and its efficacy in addressing substance abuse addiction

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