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Deep brain stimulation in addiction: a review of potential brain targets

Molecular Psychiatry volume 17, pages 572–583 (2012)Cite this article

Abstract

Deep brain stimulation (DBS) is an adjustable, reversible, non-destructive neurosurgical intervention using implanted electrodes to deliver electrical pulses to areas in the brain. DBS is currently investigated in psychiatry for the treatment of refractory obsessive–compulsive disorder, Tourette syndrome and depressive disorder. Although recent research in both animals and humans has indicated that DBS may be an effective intervention for patients with treatment-refractory addiction, it is not yet entirely clear which brain areas should be targeted. The objective of this review is to provide a systematic overview of the published literature on DBS and addiction and outline the most promising target areas using efficacy and adverse event data from both preclinical and clinical studies. We found 7 animal studies targeting six different brain areas: nucleus accumbens (NAc), subthalamic nucleus (STN), dorsal striatum, lateral habenula, medial prefrontal cortex (mPFC) and hypothalamus, and 11 human studies targeting two different target areas: NAc and STN. Our analysis of the literature suggests that the NAc is currently the most promising DBS target area for patients with treatment-refractory addiction. The mPFC is another promising target, but needs further exploration to establish its suitability for clinical purposes. We conclude the review with a discussion on translational issues in DBS research, medical ethical considerations and recommendations for clinical trials with DBS in patients with addiction.

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Acknowledgements

This work was supported by Geestkracht programme of the Netherlands Organization for Health Research and Development (ZonMw, Grant number 60-60600-97-168).

Financial Disclosures: Dr Schuurman received travel grants from Medtronic and occasional consultant fees for educational purposes.

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Authors and Affiliations

  1. Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    J Luigjes, W van den Brink, A Mazaheri & D Denys

  2. Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands

    M Feenstra & D Denys

  3. Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    P van den Munckhof & P R Schuurman

  4. Department of Anatomy and Neurosciences, Neuroscience Campus Amsterdam, VU University, Medical Center, Amsterdam, The Netherlands

    R Schippers & T J De Vries

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  1. J Luigjes
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  2. W van den Brink
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Correspondence to J Luigjes.

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Luigjes, J., van den Brink, W., Feenstra, M. et al. Deep brain stimulation in addiction: a review of potential brain targets. Mol Psychiatry 17, 572–583 (2012). https://doi.org/10.1038/mp.2011.114

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