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Disrupting disordered neurocircuitry : treating refractory psychiatric illness with neuromodulation

Tye, Susannah J., Frye, Mark A. and Lee, Kendall H. 2009, Disrupting disordered neurocircuitry : treating refractory psychiatric illness with neuromodulation, Mayo clinic proceedings, vol. 84, no. 6, pp. 522-532, doi: 10.4065/84.6.522.

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Title Disrupting disordered neurocircuitry : treating refractory psychiatric illness with neuromodulation
Author(s) Tye, Susannah J.
Frye, Mark A.
Lee, Kendall H.
Journal name Mayo clinic proceedings
Volume number 84
Issue number 6
Start page 522
End page 532
Total pages 11
Publisher Elsevier
Place of publication New York, N. Y.
Publication date 2009-06
ISSN 0025-6196
1942-5546
Keyword(s) deep brain stimulation
humans
mental disorders
nerve net
neurosurgical procedures
psychosurgery
Summary Despite the premature and somewhat infamous rise and fall of psychosurgery in the mid-20th century, the current era of functional neuromodulation proffers immense opportunity for surgical intervention in treatment-resistant psychiatric disorders. On the basis of recent successes with novel, focused, less invasive, and reversible treatment strategies for movement disorders, several therapeutic trials have been conducted to investigate the effectiveness of deep brain stimulation (DBS) in treatment-resistant depression, obsessive-compulsive disorder (OCD), and Tourette syndrome. The many anatomic targets for these psychiatric disorders are indicative of both the system-wide effects of DBS and the network-level dysfunction mediating the emotional and cognitive disturbances. To gain insight into the application of neuromodulation therapies and their further advancement, we must elucidate neuroanatomic networks involved in refractory psychiatric illness, the neurophysiological anomalies that contribute to disordered information processing therein, and the local and system-wide modulatory effects of DBS. This review discusses the history of psychosurgical procedures, recent DBS clinical data, current anatomic models of psychopathology, and possible therapeutic mechanisms of action of DBS neuromodulation. Our search criteria for PubMed included combinations of the following terms: neuromodulation, DBS, depression, OCD, Tourette syndrome, mechanism of action, and history. Dates were not restricted. As clinical and basic scientific investigations probe the neuromodulatory effects of DBS in the treatment of refractory neuropsychiatric illness, our knowledge of these disorders and our potential to treat them are rapidly expanding. Indeed, this modern era of neuromodulation may provide the key that unlocks many of the mysteries pertaining to the biological basis of disordered emotional neurocircuitry.
Language eng
DOI 10.4065/84.6.522
Field of Research 170101 Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology)
Socio Economic Objective 920111 Nervous System and Disorders
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, Mayo Foundation for Medical Education and Research
Persistent URL http://hdl.handle.net/10536/DRO/DU:30047695

Document type: Journal Article
Collection: School of Psychology
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Created: Thu, 30 Aug 2012, 15:14:27 EST by Jane Moschetti

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