Neuromodulation for Schizophrenia: New Technology for a New Era.
Introduction: Schizophrenia as a disease is one that is progressive in its nature. Current medical therapies have been able to give a reprieve, and decreased incidence, to psychotic episodes. However, as the disease progresses patients affected by this disease become ever more refractory to current pharmaceutical agents and the polypharmacy that is attempted in treatment. Additionally, many of these drugs have significant adverse side effects leaving the practitioner in a difficult predicament for treating these patients. The history of surgery for schizophrenia, among other psychiatric diseases, has a very dark past. With new technology in the use of Deep Brain Stimulators (DBS) and a strong code of ethics, the medical communities treating these diseases have been able to overcome the horrors of the past. DBS is currently being used with moderate success in the treatment of depression, obsessive compulsive disorder, Tourette’s syndrome, and anorexia nervosa. The authors believe that schizophrenia, like other psychiatric diseases, can be treated with DBS.
Methods: An exhaustive search of the literature, through PubMed and Medline, were used to compile the data and information on the use of surgery for psychiatric diseases specifically; obsessive compulsive disorder, major depressive disorder, anorexia nervosa, Tourette’s syndrome, in addition to current treatment and theoretical models of schizophrenia.
Results: The authors believe, based on current literature and models, targeting the medial-dorsal nucleus of the thalamus because of its projections to the prefrontal cortex would be an appropriate target.
Conclusion: After reviewing all the relevant literature the authors conclude that more research is necessary in human trials for the treatment of schizophrenia using DBS.
key words: Schizophrenia; Deep Brain Stimulation; Psychosurgery