Future directions in psychiatric neurosurgery: Proceedings of the 2022 American Society for Stereotactic and Functional Neurosurgery meeting on surgical neuromodulation for psychiatric disorders

Frederick L. Hitti, Alik S. Widge, Patricio Riva-Posse, Donald A. Malone, Michael S. Okun, Maryam M. Shanechi, Kelly D. Foote, Sarah H. Lisanby, Elizabeth Ankudowich, Srinivas Chivukula, Edward F. Chang, Aysegul Gunduz, Clement Hamani, Ashley Feinsinger, Cynthia S. Kubu, Winston Chiong, Jennifer A. Chandler, Rafael Carbunaru, Binith Cheeran, Robert S. RaikeRachel A. Davis, Casey H. Halpern, Nora Vanegas-Arroyave, Dejan Markovic, Sarah K. Bick, Cameron C. McIntyre, R. Mark Richardson, Darin D. Dougherty, Brian H. Kopell, Jennifer A. Sweet, Wayne K. Goodman, Sameer A. Sheth, Nader Pouratian

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective. Despite advances in the treatment of psychiatric diseases, currently available therapies do not provide sufficient and durable relief for as many as 30–40% of patients. Neuromodulation, including deep brain stimulation (DBS), has emerged as a potential therapy for persistent disabling disease, however it has not yet gained widespread adoption. In 2016, the American Society for Stereotactic and Functional Neurosurgery (ASSFN) convened a meeting with leaders in the field to discuss a roadmap for the path forward. A follow-up meeting in 2022 aimed to review the current state of the field and to identify critical barriers and milestones for progress. Design. The ASSFN convened a meeting on June 3, 2022 in Atlanta, Georgia and included leaders from the fields of neurology, neurosurgery, and psychiatry along with colleagues from industry, government, ethics, and law. The goal was to review the current state of the field, assess for advances or setbacks in the interim six years, and suggest a future path forward. The participants focused on five areas of interest: interdisciplinary engagement, regulatory pathways and trial design, disease biomarkers, ethics of psychiatric surgery, and resource allocation/prioritization. The proceedings are summarized here. Conclusion. The field of surgical psychiatry has made significant progress since our last expert meeting. Although weakness and threats to the development of novel surgical therapies exist, the identified strengths and opportunities promise to move the field through methodically rigorous and biologically-based approaches. The experts agree that ethics, law, patient engagement, and multidisciplinary teams will be critical to any potential growth in this area.

Original languageEnglish (US)
Pages (from-to)867-878
Number of pages12
JournalBrain Stimulation
Volume16
Issue number3
DOIs
StatePublished - May 1 2023

Bibliographical note

Publisher Copyright:
© 2023

Keywords

  • Deep brain stimulation (DBS)
  • Neuromodulation
  • Obsessive compulsive disorder
  • Tourette syndrome
  • Treatment resistant depression

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