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Klinische und ethische Fragen der Neuromodulation

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Angewandte Ethik in der Neuromedizin

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Zusammenfassung

Neuromodulation bezeichnet die gezielte, chronische und steuerbare Einflussnahme auf neuronale Prozesse mit dem Ziel, therapeutische Wirkungen zu erzeugen. Ein Paradebeispiel von Neuromodulation ist die tiefe Hirnstimulation (THS). THS wird am häufigsten für Bewegungsstörungen eingesetzt, zunehmend aber auch für weitere neurologische und psychiatrische Erkrankungen. Dieser Beitrag führt in die Grundlagen der Neuromodulation und die Kriterien für deren ethische Bewertung ein. Danach werden aktuelle klinische und ethische Fragen von Neuromodulation am Beispiel der THS erläutert. Der Beitrag schließt mit Empfehlungen für Forschung und klinische Weiterentwicklung von THS und anderen Methoden der Neuromodulation.

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Literatur

  • Aebi-Müller R (2014) Der urteilsunfähige Patient – eine zivilrechtliche Auslegeordnung. Jusletter 22, September 2014. Zugänglich unter: http://jusletter.weblaw.ch/juslissues/2014/771.htmlprint

  • Ambermoon P, Carter A, Hall WD et al (2011) Impulse control disorders in patients with Parkinson’s disease receiving dopamine replacement therapy: evidence and implications for the addictions field. Addiction 106(2): 283–293

    Article  PubMed  Google Scholar 

  • Beauchamp TL, Childress JF (2013) Principles of biomedical ethics, 7th edn. Oxford University Press, Oxford

    Google Scholar 

  • Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J (1987) Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol 50: 344–346

    CAS  PubMed  Google Scholar 

  • Benabid AL, Chabardes S, Mitrofanis J, Pollak P (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 8: 67–81

    Article  PubMed  Google Scholar 

  • Blomstedt P, Sjöberg RL, Hansson M et al (2013) Deep brain stimulation in the treatment of obsessive-compulsive disorder. World Neurosurg 80(6): e245–53

    Article  PubMed  Google Scholar 

  • Boccard SG, Pereira EA, Aziz TZ (2015) Deep brain stimulation for chronic pain. J Clin Neurosci 22(10): 1537–1543

    Article  PubMed  Google Scholar 

  • Chopra A, Klassen BT, Stead M (2013) Current clinical application of deep-brain stimulation for essential tremor. Neuropsychiatr Dis Treat 9: 1859–1865

    Article  PubMed  PubMed Central  Google Scholar 

  • Christen M, Müller S (2012) Current status and future challenges of deep brain stimulation in Switzerland. Swiss Med Weekly 142: w13570

    Google Scholar 

  • Christen M, Bittlinger M, Walter H et al (2012) Dealing with side effects of deep brain stimulation: lessons learned from stimulating the STN. AJOB Neurosci 3(1):37–43

    Article  Google Scholar 

  • Christen M, Ineichen C, Tanner C (2014a) How »moral« are the principles of biomedical ethics? A cross-domain evaluation of the common morality hypothesis. BMC Med Ethics 15: 47

    Article  PubMed  PubMed Central  Google Scholar 

  • Christen M, Ineichen C, Bittlinger M, Bothe H-W, Müller S (2014b) Ethical focal points in the international practice of deep brain stimulation. AJOB Neurosci 5(4): 65–80

    Article  Google Scholar 

  • Christen M, Müller S (2015) Effects of brain lesions on moral agency: ethical dilemmas in investigating moral behavior. In: Ohl F, Lee G, Illes J (eds) Ethical issues in behavioural neuroscience. Current topics in behavioral neuroscience 19. Springer, Berlin Heidelberg New York, S 159–188

    Google Scholar 

  • Fisher RS, Velasco AL (2014) Electrical brain stimulation for epilepsy. Nat Rev Neurol 10(5):261–270

    Article  PubMed  Google Scholar 

  • Hariz MI, Blomstedt P, Zrinzo L (2010) Deep brain stimulation between 1947 and 1987: the untold story. Neurosurg Focus 29(2): E1

    Article  PubMed  Google Scholar 

  • Hariz M, Blomstedt P, Zrinzo L (2013) Future of brain stimulation: new targets, new indications, new technology. Mov Disord 28(13): 1784–1792

    Article  PubMed  Google Scholar 

  • Holsheimer J (2003) Letters to the editor. Neuromodulation 6(4): 270–273

    Article  PubMed  Google Scholar 

  • Krames EF, Peckham PH, Rezai AR (eds) (2009) Neuromodulation. Academic Press, London

    Google Scholar 

  • McIntyre CC, Chaturvedi A, Shamir RR, Lempka SF (2015) Engineering the next generation of clinical deep brain stimulation technology. Brain Stimul 8(1): 21–26

    Article  PubMed  Google Scholar 

  • Mosley PE, Marsh R, Carter A (2015) Deep brain stimulation for depression: scientific issues and future directions. Aust N Z J Psychiatry 49(11): 967–978

    Article  PubMed  Google Scholar 

  • Müller S, Christen M (2011) Deep brain stimulation in Parkinsonian patients – ethical evaluation of stimulation-induced personality alterations. AJOB Neurosci 2(1): 3–13

    Article  Google Scholar 

  • Müller S, Walter H, Christen M (2014) When benefitting a patient increases the risk for harm for third persons – the case of treating pedophilic Parkinsonian patients with deep brain stimulation. Int J Law Psychiatry 37: 295–303

    Article  PubMed  Google Scholar 

  • Odekerken VJ, van Laar T, Staal MJ et al (2013) Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson’s disease (NSTAPS study): a randomised controlled trial. Lancet Neurol 12(1): 37–44

    Article  PubMed  Google Scholar 

  • Schläpfer TE, Fins JJ (2010) Deep brain stimulation and the neuroethics of responsible publishing: when one is not enough. JAMA 303(8): 775–776

    Article  Google Scholar 

  • Schrock LE, Mink JW, Woods DW et al (2015) Tourette syndrome deep brain stimulation: a review and updated recommendations. Mov Disord 30(4): 448–471

    Article  PubMed  Google Scholar 

  • Schüpbach WM, Rau J, Knudsen K et al (EARLYSTIM Study Group) (2013) Neurostimulation for Parkinson’s disease with early motor complications. N Engl J Med 368(7): 610–622

    Article  Google Scholar 

  • Schüpbach WM, Agid Y (2008) Psychosocial adjustment after deep brain stimulation in Parkinson’s disease. Nat Clin Pract Neurol 4(2): 58–59

    Article  PubMed  Google Scholar 

  • Siegfried J (1986) Effect of stimulation of the sensory nucleus of the thalamus on dyskinesia and spasticity. Rev Neurol (Paris) 142(4): 380–383

    CAS  Google Scholar 

  • Udupa K, Bahl N, Ni Z et al (2016) Cortical plasticity induction by pairing subthalamic nucleus deep-brain stimulation and primary motor cortical transcranial magnetic stimulation in Parkinson’s disease. J Neurosci 36(2): 396–404

    Article  CAS  PubMed  Google Scholar 

  • Vidailhet M, Jutras MF, Grabli D, Roze E (2013) Deep brain stimulation for dystonia. J Neurol, Neurosurg Psychiatry 84(9): 1029–1042

    Article  Google Scholar 

  • Wächter T, Mínguez-Castellanos A, Valldeoriola F et al (2011) A tool to improve pre-selection for deep brain stimulation in patients with Parkinson’s disease. J Neurol 258(4): 641–646

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Universitärer Forschungsschwerpunkt Ethik, Universität Zürich, Zollikerstrasse 115, CH-8008, Zürich, Germany

    Markus Christen

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  1. Markus Christen
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Correspondence to Markus Christen .

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Editors and Affiliations

  1. Universitätsklinik für Neurologie Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Germany

    Frank Erbguth

  2. Institut für Ethik, Geschichte und Theorie der Medizin, Ludwig-Maximilians-Universität München, München, Bayern, Germany

    Ralf J. Jox

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Christen, M. (2017). Klinische und ethische Fragen der Neuromodulation. In: Erbguth, F., Jox, R. (eds) Angewandte Ethik in der Neuromedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49916-0_11

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  • DOI: https://doi.org/10.1007/978-3-662-49916-0_11

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49915-3

  • Online ISBN: 978-3-662-49916-0

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