The hippocampus and nucleus accumbens as potential therapeutic targets for neurosurgical intervention in schizophrenia

Charles B. Mikell, Guy M. McKhann, Solomon Segal, Robert A. McGovern, Matthew B. Wallenstein, Holly Moore

Research output: Contribution to journalReview articlepeer-review

63 Scopus citations

Abstract

Schizophrenia is a chronic and disabling psychiatric illness that is often refractory to treatment. Psychotic symptoms (e.g. hallucinations and delusions) in schizophrenia are reliably correlated with excess dopamine levels in the striatum, and have more recently been related to excess metabolic activity in the hippocampus. Multiple lines of evidence suggest that aberrantly high hippocampal activity may, via hippocampal connections with the limbic basal ganglia, drive excessive dopamine release into the striatum. In the present paper, we hypothesize that inhibition or stabilization of neural activity with high-frequency electrical stimulation of the hippocampus or nucleus accumbens, through different mechanisms, would treat the positive symptoms of schizophrenia. Thus, we suggest a direction for further experimentation aimed at developing neurosurgical therapeutic approaches for this devastating disease.

Original languageEnglish (US)
Pages (from-to)256-265
Number of pages10
JournalStereotactic and Functional Neurosurgery
Volume87
Issue number4
DOIs
StatePublished - Aug 2009
Externally publishedYes

Keywords

  • Deep brain stimulation
  • Dopamine
  • Hippocampus
  • Neurostimulation
  • Nucleus accumbens
  • Psychosis
  • Schizophrenia

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