scholarly journals The nucleus accumbens and alcoholism: a target for deep brain stimulation

2018 ◽  
Vol 45 (2) ◽  
pp. E12 ◽  
Author(s):  
Allen L. Ho ◽  
Anne-Mary N. Salib ◽  
Arjun V. Pendharkar ◽  
Eric S. Sussman ◽  
William J. Giardino ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Nucleus Accumbens ◽  
Brain Stimulation ◽  
Animal Studies ◽  
Alcohol Use Disorder ◽  
Global Public Health ◽  
Future Directions ◽  
Deep Brain

Alcohol use disorder (AUD) is a difficult to treat condition with a significant global public health and cost burden. The nucleus accumbens (NAc) has been implicated in AUD and identified as an ideal target for deep brain stimulation (DBS). There are promising preclinical animal studies of DBS for alcohol consumption as well as some initial human clinical studies that have shown some promise at reducing alcohol-related cravings and, in some instances, achieving long-term abstinence. In this review, the authors discuss the evidence and concepts supporting the role of the NAc in AUD, summarize the findings from published NAc DBS studies in animal models and humans, and consider the challenges and propose future directions for neuromodulation of the NAc for the treatment of AUD.

scholarly journals Deep Brain Stimulation for Tremor: Update on Long-Term Outcomes, Target Considerations and Future Directions

2021 ◽  
Vol 10 (16) ◽  
pp. 3468
Author(s):  
Naomi I. Kremer ◽  
Rik W. J. Pauwels ◽  
Nicolò G. Pozzi ◽  
Florian Lange ◽  
Jonas Roothans ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Focused Ultrasound ◽  
Neurosurgical Procedures ◽  
Drug Resistant ◽  
Long Term Outcomes ◽  
Future Directions ◽  
Ventral Intermediate Nucleus ◽  
Deep Brain

Deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus is one of the main advanced neurosurgical treatments for drug-resistant tremor. However, not every patient may be eligible for this procedure. Nowadays, various other functional neurosurgical procedures are available. In particular cases, radiofrequency thalamotomy, focused ultrasound and radiosurgery are proven alternatives to DBS. Besides, other DBS targets, such as the posterior subthalamic area (PSA) or the dentato-rubro-thalamic tract (DRT), may be appraised as well. In this review, the clinical characteristics and pathophysiology of tremor syndromes, as well as long-term outcomes of DBS in different targets, will be summarized. The effectiveness and safety of lesioning procedures will be discussed, and an evidence-based clinical treatment approach for patients with drug-resistant tremor will be presented. Lastly, the future directions in the treatment of severe tremor syndromes will be elaborated.

Deep Brain Stimulation for Obsessive-Compulsive Disorder Affects Language

Neurosurgery ◽  
2013 ◽  
Vol 73 (5) ◽  
pp. E907-E910 ◽  
Author(s):  
A. Rosaura Polak ◽  
Anke B. Witteveen ◽  
Mariska Mantione ◽  
Martijn Figee ◽  
Pelle de Koning ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Nucleus Accumbens ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Clinical Presentation ◽  
Symptom Improvement ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

Abstract BACKGROUND AND IMPORTANCE: Deep brain stimulation (DBS) is an effective treatment for patients with refractory neuropsychiatric disorders. Along with symptom improvement, DBS may have concurrent behavioral effects that help to unravel the role of specific brain circuitries in complex human behavior. CLINICAL PRESENTATION: This article reports on 2 patients with obsessive-compulsive disorder who received DBS targeted at the nucleus accumbens that resulted in a temporary change of accent and use of vocabulary. CONCLUSION: Changes in accent and speaking manners are most likely related to direct DBS stimulation effects of the electrode targeted at the nucleus accumbens. The shift in accent, resembling foreign accent syndrome after injuries in brain language centers, has not been reported before in the course of DBS. Induction of aggressive vocabulary may be related to transient hypomanic behavior after DBS.

scholarly journals Nucleus Accumbens Deep Brain Stimulation for Alcohol Addiction – Safety and Clinical Long-term Results of a Pilot Trial

2016 ◽  
Vol 49 (04) ◽  
pp. 170-173 ◽  
Author(s):  
U. Müller ◽  
V. Sturm ◽  
J. Voges ◽  
H.-J. Heinze ◽  
I. Galazky ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Nucleus Accumbens ◽  
Brain Stimulation ◽  
Pilot Trial ◽  
Alcohol Addiction ◽  
Long Term Results ◽  
Deep Brain

Deep brain stimulation of the nucleus accumbens reduces alcohol intake in alcohol-preferring rats

2010 ◽  
Vol 29 (2) ◽  
pp. E12 ◽  
Author(s):  
Michael B. Henderson ◽  
Alan I. Green ◽  
Perry S. Bradford ◽  
David T. Chau ◽  
David W. Roberts ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Nucleus Accumbens ◽  
Alcohol Consumption ◽  
Brain Stimulation ◽  
Alcohol Intake ◽  
Drugs Of Abuse ◽  
Alcohol Preference ◽  
Stable Pattern ◽  
Deep Brain

Object The authors tested the hypothesis that deep brain stimulation (DBS) in the nucleus accumbens (NAcc) decreases alcohol intake in alcohol-preferring (P) rats after each animal has established a stable, large alcohol intake and after P rats with an established intake have been deprived of alcohol for 4–6 weeks. Methods Bipolar stimulating electrodes were bilaterally placed in the NAcc using stereotactic coordinates. In the first study, P rats (9 animals) were allowed to establish a stable pattern of alcohol intake (about 5–7 g/day) over approximately 2 weeks, and the acute effects of DBS in the NAcc (140–150 Hz, 60-μsec pulse width, and 200-μA current intensity) on alcohol intake and alcohol preference were studied. Each animal acted as its own control and received 1 hour of DBS followed by 1 hour of sham-DBS or vice versa on each of 2 sequential days. The order of testing (sham-DBS vs DBS) was randomized. In the second study, each animal was allowed to establish a stable alcohol intake and then the animal was deprived of alcohol for 4–6 weeks. Animals received DBS (6 rats) or sham-DBS (5 rats) in the NAcc for 24 hours starting when alcohol was reintroduced to each animal. Results Deep brain stimulation in the NAcc, as compared with a period of sham-DBS treatment in the same animals, acutely decreased alcohol preference. Furthermore, alcohol consumption and preference were significantly reduced in the DBS group compared with the sham treatment group during the first 24 hours that alcohol was made available after a period of forced abstinence. Conclusions The NAcc plays a key role in the rewarding and subsequent addictive properties of drugs of abuse in general and of alcohol in particular. Deep brain stimulation in the NAcc reduced alcohol consumption in P rats both acutely and after a period of alcohol deprivation. Therefore, DBS in the NAcc coupled with other neurophysiological measurements may be a useful tool in determining the role of the NAcc in the mesocorticolimbic reward circuit. Deep brain stimulation in the NAcc may also be an effective treatment for reducing alcohol consumption in patients who abuse alcohol and have not responded to other forms of therapy.

scholarly journals Deep brain stimulation for appetite disorders: a review

2018 ◽  
Vol 45 (2) ◽  
pp. E9 ◽  
Author(s):  
Alexander C. Whiting ◽  
Michael Y. Oh ◽  
Donald M. Whiting
Keyword(s):  
Anorexia Nervosa ◽  
Deep Brain Stimulation ◽  
Nucleus Accumbens ◽  
Brain Stimulation ◽  
Lateral Hypothalamus ◽  
Ventromedial Hypothalamus ◽  
Stria Terminalis ◽  
The Central Nervous System ◽  
Deep Brain

The mechanisms of appetite disorders, such as refractory obesity and anorexia nervosa, have been vigorously studied over the last century, and these studies have shown that the central nervous system has significant involvement with, and responsibility for, the pathology associated with these diseases. Because deep brain stimulation has been shown to be a safe, efficacious, and adjustable treatment modality for a variety of other neurological disorders, it has also been studied as a possible treatment for appetite disorders. In studies of refractory obesity in animal models, the ventromedial hypothalamus, the lateral hypothalamus, and the nucleus accumbens have all demonstrated elements of success as deep brain stimulation targets. Multiple targets for deep brain stimulation have been proposed for anorexia nervosa, with research predominantly focusing on the subcallosal cingulate, the nucleus accumbens, and the stria terminalis and medial forebrain bundle. Human deep brain stimulation studies that focus specifically on refractory obesity and anorexia nervosa have been performed but with limited numbers of patients. In these studies, the target for refractory obesity has been the lateral hypothalamus, ventromedial hypothalamus, and nucleus accumbens, and the target for anorexia nervosa has been the subcallosal cingulate. These studies have shown promising findings, but further research is needed to elucidate the long-term efficacy of deep brain stimulation for the treatment of appetite disorders.

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