Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-25T14:29:07.129Z Has data issue: false hasContentIssue false
  • English
  • Français

Electrical Stimulation of the Brain for Psychiatric Disorders

Published online by Cambridge University Press:  07 November 2014

Bart Nuttin ,
Loes Gabriëls ,
Paul Cosyns  and
Jan Gybels
Get access Rights & Permissions [Opens in a new window]

Abstract

Despite advances in therapies, there remain psychiatric patients who are extremely ill and cannot be helped by classic psychiatric treatments, including psychotherapy and drug therapy. Certain of these patients may be helped by use of bilateral brain lesioning. The complication rate of standard stereotactic psychosurgery techniques is very low. The main rationale for the continued experimental use of deep brain stimulation (DBS) in neurosurgery for mental disorders is its reversibility. This reversibility is not an advantage in terms of the benefits obtained, but rather if side effects emerge. In addition, electrical stimulation may provide patients with some autonomy for their treatment. The first, very preliminary results of electrical stimulation for obsessive-compulsive disorder and for a small heterogeneous group of patients with other psychiatric disorders have been published. Electrical stimulation of the brain for psychiatric disorders may become a new treatment option for certain intractable psychiatric disorders. Nevertheless, the mechanism of action of DBS in psychiatric disorders is unknown, and the experience with this modality is extremely limited. The first results look promising, but this treatment option may prove unusable for some time because of a lack of knowledge of appropriate brain stimulation targets and technical problems such as the availability of sufficient current supply.

Type
Feature Article
Information
CNS Spectrums , Volume 5 , Issue 11: Surgery for Psychiatric Disorders: Part Two , November 2000 , pp. 35 - 39
Copyright
Copyright © Cambridge University Press 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Health for All by the Year 2000: Strategies. Geneva, Switzerland: World Health Organization; 1980. WHO Official document 173.Google Scholar
2.Meyerson, BA. Neurosurgical treatment of mental disorders: introduction and indications. In: Gildenberg, PL, Tasker, RR, eds. Textbook of Stereotactic and Functional Neurosurgery. New York, NY: McGraw-Hill; 1988:1955–1964.Google Scholar
3.Cosyns, P, Caemaert, J, Haaijman, W, et al.Functional stereotactic neurosurgery for psychiatric disorders: an experience in Belgium and The Netherlands. Adv Tech Stand Neurosurg. 1994;21:239–279.CrossRefGoogle ScholarPubMed
4.Bartlett, J, Bridges, P, Kelly, D. Contemporary indications for psychosurgery. Br J Psychiatry. 1981;138:507–511.CrossRefGoogle ScholarPubMed
5.Bridges, K, Bartlett, JR, Hale, AS, et al.Psychosurgery: stereotactic subcaudate tractotomy: an indispensable treatment. Br J Psychiatry. 1994;165:599–611.CrossRefGoogle ScholarPubMed
6.Jenike, MA. Neurosurgical treatment of obsessive-compulsive disorder. Br J Psychiatry. 1998;173(suppl 35):79–90.CrossRefGoogle Scholar
7.Mindus, P, Jenike, MA. Neurosurgical treatment of malignant obsessive-compulsive disorder. In: Jenike, MA, ed. Psychiatric Clinics of North America: Obsessional Disorders. Philadelphia, Pa: W.B. Saunders and Co; 1992:921–938.Google Scholar
8.Mathew, SJ, Yudofsky, SC, McCullough, LB, et al.Attitudes toward neurosurgical procedures for Parkinson's disease and obsessive-compulsive disorder. J Neuropsychiatry Clin Neurosci. 1999;11:259–267.CrossRefGoogle ScholarPubMed
9.Baer, L, Rauch, SL, Ballantine, HT, et al.Cingulotomy for intractable obsessive-compulsive disorder: a prospective long-term follow-up of 18 patients. Arch Gen Psychiatry. 1994;52:384–392.CrossRefGoogle Scholar
10.Corkin, S. A prospective study of Cingulotomy. In: Valenstein, ES, ed. The Psychosurgery Debate. San Francisco, Calif: W.H. Freeman and Company; 1980:165–204.Google Scholar
11.Mindus, P, Edman, G, Andreewitch, SA. A prospective, long-term study of personality traits in patients with intractable obsessional illness treated by capsulotomy. Acta Psychiatr Scand. 1999;99:40–50.CrossRefGoogle ScholarPubMed
12.Earp, JD. Psychosurgery: the position of the Canadian Psychiatric Association. Can Psychiatr Assoc J. 1979;24:353–355.CrossRefGoogle ScholarPubMed
13.Mindus, P, Nyman, H. Normalization of personality characteristics in patients with incapacitating anxiety disorders after capsulotomy. Acta Psychiatr Scand. 1991;83:283–291.CrossRefGoogle ScholarPubMed
14.Sachdev, P, Hay, P. Does neurosurgery for obsessive-compulsive disorder produce personality change? J Nerv Ment Dis. 1995;183:408–413.CrossRefGoogle ScholarPubMed
15.Nyman, H, Mindus, P. Neuropsychological correlates of intractable anxiety disorder before and after capsulotomy. Acta Psychiatr Scand. 1995;91:23–31.CrossRefGoogle ScholarPubMed
16.Cummings, S, Hay, P, Lee, T, et al.Neuropsychological outcome from psychosurgery for obsessive-compulsive disorder. Aust N Z J Psychiatry. 1995;29:293–298.CrossRefGoogle Scholar
17.Starr, PA, Vitek, JL, Bakay, RAE. Ablative surgery and deep brain stimulation for Parkinson's disease. Neurosurgery. 1998;43:989–1015.CrossRefGoogle ScholarPubMed
18.Nuttin, B, Cosyns, P, Demeulemeester, H, et al.Electrical stimulation in anterior limbs of internal capsules in patients with obsessive-compulsive disorder. Lancet. 1999;354:1526.CrossRefGoogle ScholarPubMed
19.Lippitz, B, Mindus, P, Meyerson, B, et al.Obsessive-compulsive disorder and the right hemisphere: topographic analysis of lesions after anterior capsulotomy performed with thermocoagulation. Acta Neuroch Suppl (Wien). 1997;68:61–63.Google ScholarPubMed
20.Crow, HJ, Cooper, R, Philips, DG. Controlled multifocal frontal leucotomy for psychiatric illness. J Neurol Neurosurg Psychiatry. 1961;24:353–360.CrossRefGoogle ScholarPubMed
21.Crow, H. The treatment of anxiety and obsessionality with chronically implanted electrodes. In: Smith, JS, Kiloh, LG, eds. Psychosurgery and Society. Oxford, UK: Pergamom; 1977:1–3.Google Scholar
22.Obrador, S, Dierssen, G. Mental changes induced by subcortical stimulation and therapeutic lesions. Confin Neurol. 1967;29:168.CrossRefGoogle ScholarPubMed
23.Escobedo, F, Fernandez-Guardiola, A, Solis, G. Chronic stimulation of the cingulum in humans with behavior disorders. In: Laitinen, L, Livingston, K, eds. Surgical Approaches in Psychiatry. Lancaster, Great Britian: MTP Co, Ltd; 1973:65–68.Google Scholar
24.Heath, RG. Modulation of emotion with brain pacemaker: treatment for intractable psychiatric illness. J Nerv Ment Dis. 1977;165:300–316.CrossRefGoogle Scholar
25.Heath, RG, Llewellyn, R, Rouchell, A. Brain mechanisms in psychiatric illness: rationale for and results of treatment with cerebellar stimulation. In: Hitchcock, E, Ballantine, H, Meyerson, B, eds. Modern Concepts in Psychiatric Surgery. Amsterdam, NY: North-Holland Biomedical Press (Elsevier); 1979:77–84.Google Scholar
26.Dieckman, G. Chronic mediothalamic stimulation for control of phobias. In: Hitchcock, E, Ballantine, H, Meyerson, B, eds. Modern Concepts in Psychiatric Surgery. Amsterdam, NY, Oxford: North-Holland Biomedical Press (Elsevier); 1979:77–84.Google Scholar
27.Laitinen, L. Psychosurgery today. Acta Neurochir Suppl (Wien). 1988;44:158–162.Google ScholarPubMed
28.Vandewalle, V, van der Linden, C, Groenewegen, H, et al.Stereotactic treatment of Gilles de la Tourette syndrome by high frequency stimulation of the thalamus. Lancet. 1999;353:724.CrossRefGoogle ScholarPubMed
29.Krotopov, JD, Crawford, HJ, Polyakov, YI. Somatosensory event-related potential changes to painful stimuli during hypnotic analgesia: anterior cingulate cortex and anterior temporal cortex intracranial recordings. Int J Psychophysiol. 1997;27:1–8.CrossRefGoogle Scholar
30.George, MS, Sackeim, HA, Rush, AJ, et al.Vagus nerve stimulation: a new tool for brain research and therapy. Biol Psychiatry. 2000;47:273–275.CrossRefGoogle ScholarPubMed
31.Rush, AJ, George, MS, Sackeim, HA, et al.Vagus nerve stimulation for treatment-resistant depressions: a multicenter study. Biol Psychiatry. 2000;47:276–286.CrossRefGoogle ScholarPubMed