Remission of alcohol dependency following deep brain stimulation of the nucleus accumbens: valuable therapeutic implications?
Jens Kuhn,Doris Lenartz,Wolfgang Huff,S. H. Lee,Athanasios Koulousakis,J. Klosterkoetter,Volker Sturm +6 more
TLDR
A 54-year-old patient with a severe anxiety disorder and secondary depressive disorder in whom bilateral deep brain stimulation of the nucleus accumbens was carried out observes a remarkable although not primarily intended alleviation of the patient’s comorbid alcohol dependency.Abstract:
Chronic consumption of alcohol represents one of the greatest health and socioeconomic problems worldwide. We report on a 54-year-old patient with a severe anxiety disorder and secondary depressive disorder in whom bilateral deep brain stimulation (DBS) of the nucleus accumbens was carried out. Despite the absence of desired improvement in his primary disorder, we observed a remarkable although not primarily intended alleviation of the patient’s comorbid alcohol dependency. Our case report demonstrates the extremely effective treatment of alcohol dependency by means of DBS of the nucleus accumbens and may reveal new prospects in overcoming therapy resistance in dependencies in general.read more
Citations
More filters
Journal ArticleDOI
The Nucleus Accumbens: A Comprehensive Review
TL;DR: The NAc is a fascinating and potentially rich target for stereotactic neuros surgical intervention, and analysis of existing information regarding all aspects of this structure should help potentiate therapeutic advances and reduce complications from future studies of neurosurgical intervention in this region for a variety of disorders.
Journal ArticleDOI
Deep brain stimulation : from neurology to psychiatry?
Paul Krack,Paul Krack,Marwan Hariz,Marwan Hariz,Christelle Baunez,Jorge Guridi,Jose A. Obeso +6 more
TL;DR: The concept that dysfunction of motor, limbic and associative cortico-basal ganglia-thalamocortical loops underlies these various disorders, which might now be amenable to DBS treatment, is discussed.
Journal ArticleDOI
Alcohol and the human brain: a systematic review of different neuroimaging methods.
Mira Bühler,Karl Mann +1 more
TL;DR: The study of the alcoholic brain provides an heuristic model which furthers the understanding of neurodegenerative changes in general, as well as their partial reversibility with sustained abstinence, and is poised to become an important tool for generating predictions about individual brain functioning, which can then be used as a basis for personalized medicine.
Journal ArticleDOI
Deep brain stimulation in addiction: a review of potential brain targets
Judy Luigjes,W. van den Brink,Matthijs G. P. Feenstra,P. van den Munckhof,P.R. Schuurman,R. Schippers,Ali Mazaheri,T.J. De Vries,Damiaan Denys,Damiaan Denys +9 more
TL;DR: The analysis of the literature suggests that the NAc is currently the most promising DBS target area for patients with treatment-refractory addiction, and the mPFC is another promising target, but needs further exploration to establish its suitability for clinical purposes.
Journal ArticleDOI
Current Status of Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Clinical Review of Different Targets
Pelle de Koning,Martijn Figee,Pepijn van den Munckhof,P. Richard Schuurman,Damiaan Denys,Damiaan Denys +5 more
TL;DR: DBS may be a promising and safe therapy for treatment-resistant OCD and larger prospective studies including neuroimaging are needed to estimate adequately the true potential in treatment of OCD.
References
More filters
Journal ArticleDOI
Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II
TL;DR: The AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross-national study.
Journal ArticleDOI
The Neural Basis of Addiction: A Pathology of Motivation and Choice
Peter W. Kalivas,Nora D. Volkow +1 more
TL;DR: Cellular adaptations in prefrontal glutamatergic innervation of the accumbens promote the compulsive character of drug seeking in addicts by decreasing the value of natural rewards, diminishing cognitive control (choice), and enhancing glutamatorgic drive in response to drug-associated stimuli.
Journal ArticleDOI
The nucleus accumbens: a target for deep brain stimulation in obsessive-compulsive- and anxiety-disorders.
Volker Sturm,Doris Lenartz,Athanasios Koulousakis,Harald Treuer,Karl Herholz,Johannes C. Klein,Joachim Klosterkötter +6 more
TL;DR: The shell region of the right nucleus accumbens is chosen as target for deep brain stimulation (DBS) in a pilot-series of four patients with severe obsessive-compulsive- and anxiety-disorders, with significant reduction in severity of symptoms.
Journal ArticleDOI
Identification of a Signaling Network in Lateral Nucleus of Amygdala Important for Inhibiting Memory Specifically Related to Learned Fear
Gleb P. Shumyatsky,Evgeny Tsvetkov,Gaël Malleret,Svetlana Vronskaya,Michael Hatton,Lori L. Hampton,James F. Battey,Catherine Dulac,Eric R. Kandel,Vadim Y. Bolshakov +9 more
TL;DR: Genetic evidence is provided that GRP and its neural circuitry operate as a negative feedback regulating fear and establish a causal relationship between Grpr gene expression, LTP, and amygdala-dependent memory for fear.
Journal ArticleDOI
Drug Therapy for Alcohol Dependence
TL;DR: Alcohol dependence is a chronic disorder that results from a variety of genetic, psychosocial, and environmental factors and results in social problems, considerable morbidity and mortality, and high health care costs.