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Semin Neurol 2009; 29(3): 256-265
DOI: 10.1055/s-0029-1223879
© Thieme Medical Publishers

Psychiatric Neurosurgery 2009: Review and Perspective

Cynthia N. Read1 , Benjamin D. Greenberg1
  • 1Brown University/Butler Hospital, Providence, Rhode Island
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Publication History

Publication Date:
23 June 2009 (online)

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ABSTRACT

In the treatment of psychiatric disorders, modern lesion procedures and nonablative deep brain stimulation (DBS) offer a degree of hope for patients who remain severely ill and impaired despite pharmacological and behavioral treatments. The available data support the therapeutic promise of these procedures, primarily for those suffering with obsessive-compulsive disorder (OCD) or major depressive disorder (MDD). However, the use of neurosurgical treatments for psychiatric disorders must be approached with both caution and a commitment to long-term care. The data also show that psychiatric neurosurgical procedures can be implemented most successfully by dedicated interdisciplinary teams in the context of a multimodal treatment plan. Treatment using these procedures is further complicated by issues involving the criteria for patient selection, the long-term management of patients receiving psychiatric neurosurgery, and the different patterns of potential clinical benefits and burdens presented by DBS and contemporary lesion procedures.

KEYWORDS

Psychiatric neurosurgery - cingulotomy - capsulotomy - subcaudate tractomy - deep brain stimulation - major depressive disorder - obsessive-compulsive disorder

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Benjamin D GreenbergM.D. Ph.D. 

Brown University/Butler Hospital

345 Blackstone Blvd., Providence, RI 02906

Email: be3ngreenb@gmail.com

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