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Deep brain stimulation (DBS) at the interface of neurology and psychiatry
Nolan R. Williams, Michael S. Okun
Nolan R. Williams, Michael S. Okun
Published November 1, 2013
Citation Information: J Clin Invest. 2013;123(11):4546-4556. https://doi.org/10.1172/JCI68341.
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Review

Deep brain stimulation (DBS) at the interface of neurology and psychiatry

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Abstract

Deep brain stimulation (DBS) is an emerging interventional therapy for well-screened patients with specific treatment-resistant neuropsychiatric diseases. Some neuropsychiatric conditions, such as Parkinson disease, have available and reasonable guideline and efficacy data, while other conditions, such as major depressive disorder and Tourette syndrome, have more limited, but promising results. This review summarizes both the efficacy and the neuroanatomical targets for DBS in four common neuropsychiatric conditions: Parkinson disease, Tourette syndrome, major depressive disorder, and obsessive-compulsive disorder. Based on emerging new research, we summarize novel approaches to optimization of stimulation for each neuropsychiatric disease and we review the potential positive and negative effects that may be observed following DBS. Finally, we summarize the likely future innovations in the field of electrical neural-network modulation.

Authors

Nolan R. Williams, Michael S. Okun

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Figure 1

The modern version of the DBS system includes an electrode implanted into a deep brain target, which has been postulated to function as an important node that possesses the potential to modulate a dysfunctional brain circuit.

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The modern version of the DBS system includes an electrode implanted int...
The DBS lead is connected through an extension wire to an IPG (i.e., battery, neurostimulator), which is placed in the chest under the clavicle, or, less frequently, in the abdomen. The system is telemetrically programmed through the use of an external programming device to deliver pulses of electricity into the target region. These electrical pulses can modulate a circuit of interest to relieve disease symptoms. Schematic is not anatomically accurate.
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