Deep brain stimulation: a return journey from psychiatry to neurology
Identifieur interne : 000011 ( Main/Exploration ); précédent : 000010; suivant : 000012Deep brain stimulation: a return journey from psychiatry to neurology
Auteurs : Keyoumars Ashkan [Royaume-Uni] ; Paul Shotbolt [Royaume-Uni] ; Anthony S. David [Royaume-Uni] ; Michael Samuel [Royaume-Uni]Source :
- Postgraduate Medical Journal [ 0032-5473 ] ; 2013-06.
Abstract
Deep brain stimulation (DBS) has emerged as an effective neurosurgical tool to treat a range of conditions. Its use in movement disorders such as Parkinson's disease, tremor and dystonia is now well established and has been approved by the National Institute of Clinical Excellence (NICE). The NICE does, however, emphasise the need for a multidisciplinary team to manage these patients. Such a team is traditionally composed of neurologists, neurosurgeons and neuropsychologists. Neuropsychiatrists, however, are increasingly recognised as essential members given many psychiatric considerations that may arise in patients undergoing DBS. Patient selection, assessment of competence to consent and treatment of postoperative psychiatric disease are just a few areas where neuropsychiatric input is invaluable. Partly driven by this close team working and partly based on the early history of DBS for psychiatric disorders, there is increasing interest in re-exploring the potential of neurosurgery to treat patients with psychiatric disease, such as depression and obsessive–compulsive disorder. Although the clinical experience and evidence with DBS in this group of patients are steadily increasing, many questions remain unanswered. Yet, the characteristics of optimal surgical candidates, the best choice of DBS target, the most effective stimulating parameters and the extent of postoperative improvement are not clear for most psychiatric conditions. Further research is therefore required to define how DBS can be best utilised to improve the quality of life of patients with psychiatric disease.
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DOI: 10.1136/postgradmedj-2012-131520
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David</name></author><author><name sortKey="Samuel, Michael" sort="Samuel, Michael" uniqKey="Samuel M" first="Michael" last="Samuel">Michael Samuel</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:F2F86BE93F6C8E78FAC4F1212515EF7EEA4B0B46</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/postgradmedj-2012-131520</idno><idno type="url">https://api.istex.fr/document/F2F86BE93F6C8E78FAC4F1212515EF7EEA4B0B46/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000A38</idno><idno type="wicri:Area/Main/Curation">000906</idno><idno type="wicri:Area/Main/Exploration">000011</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Deep brain stimulation: a return journey from psychiatry to neurology</title><author><name sortKey="Ashkan, Keyoumars" sort="Ashkan, Keyoumars" uniqKey="Ashkan K" first="Keyoumars" last="Ashkan">Keyoumars Ashkan</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurosurgery, King's College Hospital NHS Foundation Trust, King's Health Partners, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Shotbolt, Paul" sort="Shotbolt, Paul" uniqKey="Shotbolt P" first="Paul" last="Shotbolt">Paul Shotbolt</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Neuropsychiatry Service, South London and The Maudsley NHS Foundation Trust, King's Health Partners, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="David, Anthony S" sort="David, Anthony S" uniqKey="David A" first="Anthony S" last="David">Anthony S. 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Its use in movement disorders such as Parkinson's disease, tremor and dystonia is now well established and has been approved by the National Institute of Clinical Excellence (NICE). The NICE does, however, emphasise the need for a multidisciplinary team to manage these patients. Such a team is traditionally composed of neurologists, neurosurgeons and neuropsychologists. Neuropsychiatrists, however, are increasingly recognised as essential members given many psychiatric considerations that may arise in patients undergoing DBS. Patient selection, assessment of competence to consent and treatment of postoperative psychiatric disease are just a few areas where neuropsychiatric input is invaluable. Partly driven by this close team working and partly based on the early history of DBS for psychiatric disorders, there is increasing interest in re-exploring the potential of neurosurgery to treat patients with psychiatric disease, such as depression and obsessive–compulsive disorder. Although the clinical experience and evidence with DBS in this group of patients are steadily increasing, many questions remain unanswered. Yet, the characteristics of optimal surgical candidates, the best choice of DBS target, the most effective stimulating parameters and the extent of postoperative improvement are not clear for most psychiatric conditions. Further research is therefore required to define how DBS can be best utilised to improve the quality of life of patients with psychiatric disease.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Ashkan, Keyoumars" sort="Ashkan, Keyoumars" uniqKey="Ashkan K" first="Keyoumars" last="Ashkan">Keyoumars Ashkan</name></region><name sortKey="David, Anthony S" sort="David, Anthony S" uniqKey="David A" first="Anthony S" last="David">Anthony S. David</name><name sortKey="Samuel, Michael" sort="Samuel, Michael" uniqKey="Samuel M" first="Michael" last="Samuel">Michael Samuel</name><name sortKey="Shotbolt, Paul" sort="Shotbolt, Paul" uniqKey="Shotbolt P" first="Paul" last="Shotbolt">Paul Shotbolt</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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