Preliminary findings in ablating the nucleus accumbens using stereotactic surgery for alleviating psychological dependence on alcohol

Wu, Heming; Wang, Xuelian; Chang, Chongwang; Li, Nan; Gao, Li; Geng, Ning; Ma, Jing; Zhao, Wei; Gao, Guodong

doi:10.1016/j.neulet.2010.02.019

Cited by 45 publications

(25 citation statements)

References 21 publications

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“…The severity of alcohol dependence and of alcohol cravings significantly decreased in this group. After a follow-up period of 6-27 months, only 2 of 12 patients had relapsed [124].…”

Section: Reviewmentioning

confidence: 95%

Deep brain stimulation in Parkinson disease—what went wrong?

Krack

Hariz

2010

Nat Rev Neurol

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“…The severity of alcohol dependence and of alcohol cravings significantly decreased in this group. After a follow-up period of 6-27 months, only 2 of 12 patients had relapsed [124].…”

Section: Reviewmentioning

confidence: 95%

Deep brain stimulation in Parkinson disease—what went wrong?

Krack

Hariz

2010

Nat Rev Neurol

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“…Bilateral ablation of the NAc has been attempted for the treatment of opiate [309,318] and alcohol [319] addiction with evidence of efficacy, although following surgery, changes in personality characteristics, short-term memory, and attention have been noted [308]. Long-term follow-up notes continued effectiveness [318], but a lack of extensive long-term data has halted the use of ablative treatments, especially in light of the ethical concerns of intentionally causing irreversible damage to brain structures with as many cognitive and behavioral functions as the NAc.…”

Section: Surgerymentioning

confidence: 99%

The Nucleus Accumbens: A Comprehensive Review

Salgado

Kaplitt²

2015

Stereotact Funct Neurosurg

379

289

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There is increasing interest among functional neurosurgeons in the potential for novel therapies to impact upon diseases beyond movement disorders and pain. A target of increasing interest is the nucleus accumbens (NAc), which has long been studied as a key brain region mediating a variety of behaviors, including reward and satisfaction. As such, focal modulation of the biology of the NAc with deep brain stimulation or novel biological therapies such as gene therapy or cell transplantation could have a major impact upon disorders such as depression and drug addiction. In order to both develop appropriate therapies and then deliver them in an effective fashion, a thorough understanding of the biology, physiology, and anatomy of the NAc is critical. Here, we review the existing literature regarding several areas critical to the development of new therapies, including the known pharmacology, physiology, and connectivity of the NAc, as well as evidence supporting the potential for various NAc surgical therapies in animal models. We then review the relevant anatomy of the NAc, with particular attention to the surgical anatomy, imaging, and targeting necessary to facilitate a proper localization and delivery of new agents to this region. The NAc is a fascinating and potentially rich target for stereotactic neurosurgical intervention, and analysis of existing information regarding all aspects of this structure should help potentiate therapeutic advances and reduce complications from future studies of neurosurgical intervention in this region for a variety of disorders.

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“…Ablative surgeries targeted at the NAcc have been used for several years in China with mixed results, but a relapse rate of 50% and ethical concerns now limit the use of destructive procedures in the treatment of addiction. 163,304,305 Although sparse, clinical data regarding the efficacy of NAcc stimulation exists in the literature in small case series. In 1 case study, a patient who was treated with bilateral NAcc stimulation for heroin addiction underwent explantation at 3 years postoperation, but remained abstinent from opioids to the last follow-up at 6 years.…”

Section: Addiction and Substance Use Disordermentioning

confidence: 99%

Deep brain stimulation for psychiatric disorders: where we are now

Cleary

Ozpinar

Raslan

et al. 2015

FOC

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Fossil records showing trephination in the Stone Age provide evidence that humans have sought to influence the mind through physical means since before the historical record. Attempts to treat psychiatric disease via neurosurgical means in the 20th century provided some intriguing initial results. However, the indiscriminate application of these treatments, lack of rigorous evaluation of the results, and the side effects of ablative, irreversible procedures resulted in a backlash against brain surgery for psychiatric disorders that continues to this day. With the advent of psychotropic medications, interest in invasive procedures for organic brain disease waned. Diagnosis and classification of psychiatric diseases has improved, due to a better understanding of psychiatric patho-physiology and the development of disease and treatment biomarkers. Meanwhile, a significant percentage of patients remain refractory to multiple modes of treatment, and psychiatric disease remains the number one cause of disability in the world. These data, along with the safe and efficacious application of deep brain stimulation (DBS) for movement disorders, in principle a reversible process, is rekindling interest in the surgical treatment of psychiatric disorders with stimulation of deep brain sites involved in emotional and behavioral circuitry. This review presents a brief history of psychosurgery and summarizes the development of DBS for psychiatric disease, reviewing the available evidence for the current application of DBS for disorders of the mind.

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Preliminary findings in ablating the nucleus accumbens using stereotactic surgery for alleviating psychological dependence on alcohol

Cited by 45 publications

References 21 publications

Deep brain stimulation in Parkinson disease—what went wrong?

Deep brain stimulation in Parkinson disease—what went wrong?

The Nucleus Accumbens: A Comprehensive Review

Deep brain stimulation for psychiatric disorders: where we are now

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