Treating addiction with deep brain stimulation: Ethical and legal considerations

Lo, Clara; Mane, Mansee; Kim, Jee Hyun; Berk, Michael; Lee, Kendall H.; Yuen, Jason

doi:10.1016/j.drugpo.2023.103964

Cited by 4 publications

(2 citation statements)

References 67 publications

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“…In some cases, due to the severity of the disease, these patients may be more willing to take risks associated with invasive DBS procedures, especially after the failure of conservative treatments. [ 75 ] Informed consent should be autonomous and free of coercion. However, some experts have the opinion that people with an addiction have limited capacity to be autonomous due to their addiction, which may coerce their behavior.…”

Section: Discussionmentioning

confidence: 99%

Role of deep brain stimulation (DBS) in addiction disorders

Iqbal,

Mansour,

Saboor

et al. 2023

Surgical Neurology International

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Background: Addiction disorders pose significant challenges to public health, necessitating innovative treatments. This assesses deep brain stimulation (DBS) as a potential intervention for addiction disorders. Methods: A literature review was carried out with a focus on the role of DBS in addiction disorders and its future implications in neurosurgical research. Results: The online literature shows that DBS precisely modulates certain brain regions to restore addiction-related neural circuits and promote behavioral control. Conclusion: Preclinical evidence demonstrates DBS’s potential to rebalance neural circuits associated with addiction, and early clinical trials provide encouraging outcomes in enhancing addiction-related outcomes. Ethical considerations, long-term safety, and personalized patient selection require further investigation.

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Section: Discussionmentioning

confidence: 99%

Role of deep brain stimulation (DBS) in addiction disorders

Iqbal,

Mansour,

Saboor

et al. 2023

Surgical Neurology International

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“…In addition, the present study suggests that intermittent or continuous measurement of tonic dopamine levels may serve as a potential biomarker for closed-loop DBS for substance use disorder. However, the risks of implanting a separate sensing electrode and the ethics of such interventions should be considered ( Lo et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Oxycodone-induced dopaminergic and respiratory effects are modulated by deep brain stimulation

et al. 2023

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Introduction: Opioids are the leading cause of overdose death in the United States, accounting for almost 70,000 deaths in 2020. Deep brain stimulation (DBS) is a promising new treatment for substance use disorders. Here, we hypothesized that VTA DBS would modulate both the dopaminergic and respiratory effect of oxycodone.Methods: Multiple-cyclic square wave voltammetry (M-CSWV) was used to investigate how deep brain stimulation (130 Hz, 0.2 ms, and 0.2 mA) of the rodent ventral segmental area (VTA), which contains abundant dopaminergic neurons, modulates the acute effects of oxycodone administration (2.5 mg/kg, i.v.) on nucleus accumbens core (NAcc) tonic extracellular dopamine levels and respiratory rate in urethane-anesthetized rats (1.5 g/kg, i.p.).Results: I.V. administration of oxycodone resulted in an increase in NAcc tonic dopamine levels (296.9 ± 37.0 nM) compared to baseline (150.7 ± 15.5 nM) and saline administration (152.0 ± 16.1 nM) (296.9 ± 37.0 vs. 150.7 ± 15.5 vs. 152.0 ± 16.1, respectively, p = 0.022, n = 5). This robust oxycodone-induced increase in NAcc dopamine concentration was associated with a sharp reduction in respiratory rate (111.7 ± 2.6 min−1 vs. 67.9 ± 8.3 min−1; pre- vs. post-oxycodone; p < 0.001). Continuous DBS targeted at the VTA (n = 5) reduced baseline dopamine levels, attenuated the oxycodone-induced increase in dopamine levels to (+39.0% vs. +95%), and respiratory depression (121.5 ± 6.7 min−1 vs. 105.2 ± 4.1 min−1; pre- vs. post-oxycodone; p = 0.072).Discussion: Here we demonstrated VTA DBS alleviates oxycodone-induced increases in NAcc dopamine levels and reverses respiratory suppression. These results support the possibility of using neuromodulation technology for treatment of drug addiction.

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Deep brain stimulation for psychostimulant use disorders

Swinford-Jackson,

Pierce

2023

J Neural Transm

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Treating addiction with deep brain stimulation: Ethical and legal considerations

Cited by 4 publications

References 67 publications

Role of deep brain stimulation (DBS) in addiction disorders

Role of deep brain stimulation (DBS) in addiction disorders

Oxycodone-induced dopaminergic and respiratory effects are modulated by deep brain stimulation

Deep brain stimulation for psychostimulant use disorders

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