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To date more than eighty thousand patients worldwide have received deep brain stimulation (DBS), mainly in order to alleviate symptoms of treatment-resistant disorders such as tremor associated with Parkinson’s disease, essential tremor, chronic pain, epilepsy, obsessive compulsive disorder, major depression and Tourette syndrome. The number of indications for neurological and psychiatric conditions using this technology is rapidly increasing, raising important societal and ethical issues that cannot be dealt with by scientists and clinicians on their own, but need discussions among all possible stakeholders on questions such as: what are the comprehensive risks and benefits of this technology? what is the real impact on patients’ life, in terms of health, quality of life and personal identity? This Research Topic provides an overview of potentials and limitations of deep brain stimulation as used to treat neurological and psychiatric conditions, bringing together Mini Reviews, Perspectives and Opinion papers from key stakeholders interested in the development and social impact of this technology. It is also a continuation of the debate that started among scientists, clinicians, patients, sociologists, journalists, philosophers and other experts during the “brains in dialogue on deep brain stimulation” workshop that was organized in September 2010 in Warsaw, Poland, by the FP7 project bid – brains in dialogue (www.neuromedia.eu) coordinated by the Interdisciplinary Laboratory of SISSA (Trieste, Italy).
The electrifying, forgotten history of Robert Heath's brain pacemaker, investigating the origins and ethics of one of today's most promising medical breakthroughs: deep brain stimulation The technology invented by psychiatrist Robert G. Heath in the 1950s and '60s has been described as among the most controversial experiments in US history. His work was alleged at the time to be part of MKUltra, the CIA's notorious "mind control" project. His research subjects included incarcerated convicts and gay men who wished to be "cured" of their sexual preference. Yet his cutting-edge research and legacy were quickly buried deep in Tulane University's archives. Investigative science journalist Lone Frank now tells the complete sage of this passionate, determined doctor and his groundbreaking neuroscience. More than fifty years after Heath's experiments, this very same treatment is becoming mainstream practice in modern psychiatry for everything from schizophrenia, anorexia, and compulsive behavior to depression, Parkinson's, and even substance addiction. Lone Frank uncovered lost documents and accounts of Heath's trailblazing work. She tracked down surviving colleagues and patients, and she delved into the current support for deep brain stimulation by scientists and patients alike. What has changed? Why do we today unquestioningly embrace this technology as a cure? How do we decide what is a disease of the brain to be cured and what should be allowed to remain unrobed and unprodded? And how do we weigh the decades of criticism against the promise of treatment that could be offered to millions of patients? Elegantly written and deeply fascinating, The Pleasure Shock weaves together biography, scientific history, and medical ethics. It is an adventure into our ever-shifting views of the mind and the fateful power we wield when we tinker with the self.
Chronic electrical stimulation of the brain has demonstrated excellent outcomes in patients with Parkinson’s disease and has recently also been applied to various other neurological diseases. This comprehensive, up-to-date textbook will meet the needs of all who wish to learn more about the application of deep brain stimulation and will provide a sound basis for safe and accurate surgery. The book comprises two main parts, the first of which presents relevant anatomical and functional background information on the basal ganglia, thalamus and other brain structures as well as on the mechanism of brain stimulation. The second part describes clinical studies on deep brain stimulation, covering results in a range of movement disorders and psychiatric diseases and also important aspects of instrumentation and technique. The authors are outstanding scientists and experts in the field from across the world.
An iconoclast in-depth analysis of the current understanding of DBS: efficacy, safety, indications, selection criteria and post-operative management. This book is an epistemic analysis of the presumptions, assumptions and fallacies. It provides the revolutionary potential and the complexity of DBS in changing healthcare delivery; the ethics are discussed in detail.
This book provides a state-of-the-art overview of our current understanding of deep brain stimulation (DBS) for the treatment of neurological and psychiatric disorders. With a broad multidisciplinary scope, it presents contributions from leading experts in the field from Europe and America, who share not only their knowledge, but their experience as well. The book focuses both on basic and theoretical aspects of DBS, as well as clinical and practical aspects. It follows an evidence-based approach, and where possible offers clinical recommendations based on published guidelines. It starts with a general section, which discusses basic principles and general considerations. This is followed a sections dedicated to neurological disorders, and psychiatric disorders, in which only accepted indications are discussed. All experimental indications are discussed in the final chapter. The text is supplemented with numerous illustrations. Intended for medical specialists and residents involved in the treatment of patients with DBS, it also appeals to other professionals working with DBS patients, such as psychologists, nurses, physiotherapists, as well as basic and clinical neuroscientists.
Essential reference guide for clinicians working with DBS patients, fully revised throughout with new chapters on epilepsy and psychiatric disorders.
Deep Brain Stimulation addresses the practical tips required to program and manage deep brain stimulation devices in the clinic. The number of deep brain stimulation devices worldwide will soon eclipse 200,000 and is an approved surgical treatment for medically refractory neurological movement disorders such as Parkinson disease, tremors, and dystonia. It is, therefore, inevitable that clinicians and nurses will require the necessary tools, and exemplary real-life cases, to manage these complex patients. This book offers a case-based approach to common and uncommon neurologic problems related to deep brain stimulator problems. Each case is a clinical pearl, accompanied by a discussion as well as practical tips to improve patient management.
Considered the largest breakthrough in the treatment of Parkinson's disease in the past 40 years, Deep Brain Stimulation (DBS) is a pioneering procedure of neurology and functional neurosurgery, forging enormous change and growth within the field. The first comprehensive text devoted to this surgical therapy, Deep Brain Stimulation for Parkinson's
Personalized Psychiatry presents the first book to explore this novel field of biological psychiatry that covers both basic science research and its translational applications. The book conceptualizes personalized psychiatry and provides state-of-the-art knowledge on biological and neuroscience methodologies, all while integrating clinical phenomenology relevant to personalized psychiatry and discussing important principles and potential models. It is essential reading for advanced students and neuroscience and psychiatry researchers who are investigating the prevention and treatment of mental disorders. - Combines neurobiology with basic science methodologies in genomics, epigenomics and transcriptomics - Demonstrates how the statistical modeling of interacting biological and clinical information could transform the future of psychiatry - Addresses fundamental questions and requirements for personalized psychiatry from a basic research and translational perspective