TY - JOUR
T1 - Charting the road forward in psychiatric neurosurgery
T2 - Proceedings of the 2016 American Society for Stereotactic and Functional Neurosurgery workshop on neuromodulation for psychiatric disorders
AU - Bari, Ausaf A.
AU - Mikell, Charles B.
AU - Abosch, Aviva
AU - Ben-Haim, Sharona
AU - Buchanan, Robert J.
AU - Burton, Allen W.
AU - Carcieri, Stephen
AU - Cosgrove, G. Rees
AU - D'Haese, Pierre Francois
AU - Daskalakis, Zafiris Jeffrey
AU - Eskandar, Emad N.
AU - Gerrard, Jason L.
AU - Goodman, Wayne K.
AU - Greenberg, Benjamin David
AU - Gross, Robert E.
AU - Hamani, Clement
AU - Kiss, Zelma H.T.
AU - Konrad, Peter
AU - Kopell, Brian H.
AU - Krinke, Lothar
AU - Langevin, Jean Philippe
AU - Lozano, Andres M.
AU - Malone, Donald
AU - Mayberg, Helen S.
AU - Miller, Jonathan P.
AU - Patil, Parag G.
AU - Peichel, Delea
AU - Petersen, Erika A.
AU - Rezai, Ali R.
AU - Richardson, R. Mark
AU - Riva-Posse, Patricio
AU - Sankar, Tejas
AU - Schwalb, Jason M.
AU - Simpson, Helen Blair
AU - Slavin, Konstantin
AU - Stypulkowski, Paul H.
AU - Tosteson, Tor
AU - Warnke, Peter
AU - Willie, Jon T.
AU - Zaghloul, Kareem A.
AU - Neimat, Joseph S.
AU - Pouratian, Nader
AU - Sheth, Sameer A.
N1 - Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Objective Refractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive-compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016. Design Here we summarise the proceedings of the workshop. Participants discussed a number of issues of importance to the community. First, we discussed how to interpret results from the recent pivotal trials of DBS for OCD and depression. We then reviewed what can be learnt from lesions and closed-loop neurostimulation. Subsequently, representatives from the National Institutes of Health, the Food and Drug Administration and industry discussed their views on neuromodulation for psychiatric disorders. In particular, these third parties discussed their criteria for moving forward with new trials. Finally, we discussed the best way of confirming safety and efficacy of these therapies, including registries and clinical trial design. We close by discussing next steps in the journey to new neuromodulatory therapies for these devastating illnesses. Conclusion Interest and motivation remain strong for deep brain stimulation for psychiatric disease. Progress will require coordinated efforts by all stakeholders.
AB - Objective Refractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive-compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016. Design Here we summarise the proceedings of the workshop. Participants discussed a number of issues of importance to the community. First, we discussed how to interpret results from the recent pivotal trials of DBS for OCD and depression. We then reviewed what can be learnt from lesions and closed-loop neurostimulation. Subsequently, representatives from the National Institutes of Health, the Food and Drug Administration and industry discussed their views on neuromodulation for psychiatric disorders. In particular, these third parties discussed their criteria for moving forward with new trials. Finally, we discussed the best way of confirming safety and efficacy of these therapies, including registries and clinical trial design. We close by discussing next steps in the journey to new neuromodulatory therapies for these devastating illnesses. Conclusion Interest and motivation remain strong for deep brain stimulation for psychiatric disease. Progress will require coordinated efforts by all stakeholders.
KW - Depression
KW - Electrical stimulation
KW - Psychiatry
KW - Stereotaxic surgery
UR - http://www.scopus.com/inward/record.url?scp=85043590945&partnerID=8YFLogxK
U2 - 10.1136/jnnp-2017-317082
DO - 10.1136/jnnp-2017-317082
M3 - Article
C2 - 29371415
AN - SCOPUS:85043590945
SN - 0022-3050
VL - 89
SP - 886
EP - 896
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
IS - 8
ER -