Pathologies of Decision-Making

2020 ◽  
pp. 127-132
Author(s):  
Thomas Boraud
Keyword(s):  
Neural Network ◽  
Decision Making ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
The Neural Network ◽  
Decision Making System ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders ◽  
Deep Brain

This chapter explores the pathophysiology of neural conditions related to the neural network of decision-making. If humans are not fully rational, they manage to pretend to be most of the time. Some individuals are distinguished by traits that influence their decision-making, such as impulsiveness, procrastination, and stubbornness. These behaviours are so common that they are not considered pathological. There are, however, cases in which the decision-making system is dysfunctional enough for this irrationality to go beyond socially acceptable norms. This is the field of neurological and psychiatric syndromes of decision-making. The chapter then examines in detail obsessive-compulsive disorders (OCDs), Tourette’s syndrome, Parkinson's disease, and hyperdopaminergic syndromes. It also describes the deep brain stimulation paradox.

P02-206 - Multiple deep brain stimulation targets for refractory obsessive compulsive disorders

2010 ◽  
Vol 25 ◽  
pp. 830
Author(s):  
A. Moura ◽  
L. Cif ◽  
V. Gonzalez Martinez ◽  
D. Capdevielle ◽  
A. Ionita ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders ◽  
Deep Brain

scholarly journals Deep Brain Stimulation in Neurosurgical Practice and Research: Its Application and Ethical Issues

2020 ◽  
Vol 10 (1) ◽  
pp. 92-96
Author(s):  
Abu Sadat Mohammad Nurunanbi ◽  
Miliva Mozaffor ◽  
Md Joynul Islam ◽  
Kaisar Haroon
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Ethical Issues ◽  
Human Experimentation ◽  
Obsessive Compulsive ◽  
Ethical Concerns ◽  
Neurosurgical Treatment ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders ◽  
Deep Brain

Deep brain stimulation (DBS), a form of neuromodulation, is recognized as a therapeutic venture for the management of chronic pain, the evaluation and management of epilepsy, and the treatment of Parkinson’s disease and other movement disorders. Clinical investigators are conducting more trials for its further use in obsessive compulsive disorders (OCD), depression, and traumatic brain injury. It is imperative to address the ethical concerns of such innovative neurosurgical treatment and research with human experimentation in the respective arena. The term ‘neurosurgical ethics’ is a moral approach towards ethical problems emerging from our day to day neurosurgical practice and research as well as current and future innovation in the field. The review paper outlined the procedures of DBS, as currently used in therapeutic and experimental applications and to discuss the ethical concerns regarding this innovative procedure. Bang. J Neurosurgery 2020; 10(1): 92-96

scholarly journals Elucidating neural network changes induced by deep brain stimulation for OCD

Brain ◽  
2020 ◽  
Vol 143 (5) ◽  
pp. 1293-1296
Author(s):  
Jens Kuhn ◽  
Juan Carlos Baldermann
Keyword(s):  
Neural Network ◽  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

This scientific commentary refers to ‘Deep brain stimulation modulates directional limbic connectivity in obsessive-compulsive disorder’, by Fridgeirsson etal. (doi:10.1093/brain/awaa100).

Impulsivity and decision-making in obsessive-compulsive disorder after effective deep brain stimulation or treatment as usual

CNS Spectrums ◽  
2018 ◽  
Vol 23 (5) ◽  
pp. 333-339 ◽  
Author(s):  
Giacomo Grassi ◽  
Martijn Figee ◽  
Pieter Ooms ◽  
Lorenzo Righi ◽  
Takashi Nakamae ◽  
...  
Keyword(s):  
Decision Making ◽  
Deep Brain Stimulation ◽  
Effective Treatment ◽  
Brain Stimulation ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Treatment As Usual ◽  
Compulsive Disorder ◽  
Reflection Impulsivity ◽  
Deep Brain

ObjectiveImpulsivity and impaired decision-making have been proposed as obsessive-compulsive disorder (OCD) endophenotypes, running in OCD and their healthy relatives independently of symptom severity and medication status. Deep brain stimulation (DBS) targeting the ventral limb of the internal capsule (vALIC) and the nucleus accumbens (Nacc) is an effective treatment strategy for treatment-refractory OCD. The effectiveness of vALIC-DBS for OCD has been linked to its effects on a frontostriatal network that is also implicated in reward, impulse control, and decision-making. While vALIC-DBS has been shown to restore reward dysfunction in OCD patients, little is known about the effects of vALIC-DBS on impulsivity and decision-making. The aim of the study was to compare cognitive impulsivity and decision-making between OCD patients undergoing effective vALIC-DBS or treatment as usual (TAU), and healthy controls.MethodsWe used decision-making performances under ambiguity on the Iowa Gambling Task and reflection impulsivity on the Beads Task to compare 20 OCD patients effectively treated with vALIC-DBS, 40 matched OCD patients undergoing effective TAU (medication and/or cognitive behavioural therapy), and 40 healthy subjects. Effective treatment was defined as at least 35% improvement of OCD symptoms.ResultsOCD patients, irrespective of treatment modality (DBS or TAU), showed increased reflection impulsivity and impaired decision-making compared to healthy controls. No differences were observed between OCD patients treated with DBS or TAU.ConclusionOCD patients effectively treated with vALIC-DBS or TAU display increased reflection impulsivity and impaired decision-making independent of the type of treatment.

scholarly journals Deep brain stimulation (DBS) in resistant mental disorders

2020 ◽  
Vol 21 (2) ◽  
pp. 84-94
Author(s):  
Małgorzata Romaniuk ◽  
Konrad Suswał ◽  
Aleksandra Skałecka ◽  
Maria Gromek ◽  
Martyna Kozłowska ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Brain Activity ◽  
Bipolar Affective Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Promising Therapeutic Target ◽  
Significant Clinical Improvement ◽  
Obsessive Compulsive Disorders ◽  
Deep Brain

AbstractIntroduction: Deep Brain Stimulation can directly alter brain activity in a controlled manner and the effect is reversible. The mechanism is that the electrode acts locally on neural activity, which is transferred to monosynchronous and multisynaptic network connections.Methods: We present studies conducted on a group of patients that show an improvement in mental state after Deep Brain Stimulation.Material: The diseases we included in our work are: Obsessive-Compulsive Disorder, Eating Disorder, Depression and Bipolar Affective Disorder.Discussion: The use of deep brain stimulation can inhibit development of acute state of patients and improve both psychiatric features and the time of remission. The results indicate the greatest effectiveness of Deep Brain Stimulation in Obsessive-Compulsive Disorders.Conclusions: Brain stimulation may be a promising therapeutic target in mental illness. In a properly selected location, it can contribute to a significant clinical improvement however further research in this direction is necessary.

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