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Annu Rev Med. 2012;63:511-24. doi: 10.1146/annurev-med-052209-100401. Epub 2011 Oct 27.

Deep brain stimulation for intractable psychiatric disorders.

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1
Department of Psychiatry, Friedman Brain Institute of the Mount Sinai School of Medicine, New York, New York 10029, USA. wayne.goodman@mssm.edu

Abstract

Deep brain stimulation (DBS) has virtually replaced ablative neurosurgery for use in medication-refractory movement disorders. DBS is now being studied in severe psychiatric conditions, such as treatment-resistant depression (TRD) and intractable obsessive-compulsive disorder (OCD). Effects of DBS have been reported in ∼100 cases of OCD and ∼50 cases of TRD for seven (five common) anatomic targets. Although these published reports differ with respect to study design and methodology, the overall response rate appears to exceed 50% in OCD for some DBS targets. In TRD, >50% of patients responded during acute and long-term bilateral electrical stimulation in a different target. DBS was generally well tolerated in both OCD and TRD, but some unique, target- and stimulation-specific adverse effects were observed (e.g., hypomania). Further research is needed to test the efficacy and safety of DBS in psychiatric disorders, compare targets, and identify predictors of response.

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