History of “Psychiatric” Deep Brain Stimulation: A Critical Appraisal
Recent published statements on deep brain stimulation (DBS) claim that DBS was developed first for movement disorders and is now applied in psychiatry, that it was the behavioral and psychiatric side effects of DBS in the subthalamic nucleus (STN) in parkinsonian patients that prompted investigation of DBS in psychiatry, and that neurosurgeons should not act alone in this field, but should be within multidisciplinary teams in order not to repeat abuses of the past. I conducted a review of old literature since the birth of human stereotactic neurosurgery in 1947 and established the following: (1) the first applications of DBS in the early 1950s were in the field of psychiatry and behavior, and were promoted mainly by neurologists and psychiatrists; (2) some of these old psychiatric applications of DBS were found to be dubious and precarious even by yesterday’s ethical standards; (3) modern DBS for the treatment of psychiatric illness started in 1999 on the initiative of neurosurgeons who involved from the very beginning psychiatrists, and these first applications of DBS in neuropsychiatry had nothing to do with nonmotor side effects of STN DBS; (4) because of the resurgence of interest in psychiatric DBS, true multidisciplinary guidelines should be drafted with participation of all specialties involved.
KeywordsDeep brain stimulation Psychosurgery History Ethics
Conflicts of Interest
The author has occasionally received reimbursement for travel expenses and honoraria for speaking at meetings from Medtronic.
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