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Brain Sci. 2018 Jan 27;8(2). pii: E21. doi: 10.3390/brainsci8020021.

Nucleus Accumbens Deep Brain Stimulation in Patients with Substance Use Disorders and Delay Discounting.

Author information

1
Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany. canan.peisker@uk-koeln.de.
2
Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany. thomas.schueller@uk-koeln.de.
3
Department of Psychology, Biological Psychology, University of Cologne, Bernhard-Feilchenfeld-Straße 11, 50969 Cologne, Germany. jan.peters@uni-koeln.de.
4
Department of Psychology, Biological Psychology, University of Cologne, Bernhard-Feilchenfeld-Straße 11, 50969 Cologne, Germany. ben.jonathan.wagner@uni-koeln.de.
5
Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, Germany. leonhard_schilbach@psych.mpg.de.
6
Department of Psychiatry, Otto-von-Guericke-University of Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany. ulfmueller@gmail.com.
7
Pychosomatic Hospital Buching, Rauhenbichl, 87642 Halblech, Germany. ulfmueller@gmail.com.
8
Department of Stereotactic and Functional Neurosurgery, Medical Faculty, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany. veerle.visser-vandewalle@uk-koeln.de.
9
Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany. jens.kuhn@evkln.de.
10
Department of Psychiatry, Psychotherapy and Psychosomatic, Johanniter Hospital Oberhausen, Steinbrinkstraße 96a, 46145 Oberhausen, Germany. jens.kuhn@evkln.de.

Abstract

Deep brain stimulation (DBS) of the nucleus accumbens (NAc) shows first promising results in patients with severe substance use disorder (SUD), a patient group known to have deficits in self-control. One facet of self-control is the ability to forego smaller sooner rewards in favor of larger later rewards (delay discounting, DD). The NAc has been suggested to integrate motivational information to guide behavior while the consequences of NAc-DBS on DD are unknown. To this end, nine patients with SUD performed a DD task with DBS on and after a 24 h DBS off period. Furthermore, 18 healthy controls were measured to assess possible alterations in DD in patients with SUD. Our findings implicate that DD was not significantly modulated by NAc-DBS and also that patients with SUD did not differ from healthy controls. While null results must be interpreted with caution, the commonly observed association of impaired DD in SUD might suggest a long-term effect of NAc-DBS that was not sufficiently modulated by a 24 h DBS off period.

KEYWORDS:

alcohol use disorder; deep brain stimulation; delay discounting; nucleus accumbens; opioid use disorder; self-control; substance use disorder

Conflict of interest statement

Peisker, Schüller, Peters, Wagner, Müller, Schilbach and Visser-Vandewalle declare no conflict of interest. In the last two years, Kuhn has received research support from AstraZeneca, Lilly, Lundbeck, and Otsuka Pharma for lecturing at conferences and financial support to travel. Kuhn received financial support for IIT-DBS studies (not the present investigation) from Medtronic GmbH (Meerbusch, Germany). The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

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