Psychiatrische Indikationen für die tiefe Hirnstimulation

Zusammenfassung

Es gibt eine beachtliche Anzahl psychiatrischer Patienten, denen mit herkömmlicher pharmakologischer Behandlung oder Psychotherapie nicht geholfen werden kann. Insbesondere Ergebnisse aus der funktionellen Bildgebung haben zur Entwicklung der tiefen Hirnstimulation (THS) geführt. In diesem Beitrag wird die Anwendung der THS bei therapieresistenter Depression und Zwang beschrieben und die Auswahl verschiedener Ziele diskutiert. Erste Studien haben gezeigt, dass mithilfe der THS dysfunktionale neuronale Netze bei Depression und Zwang moduliert werden können. Dies macht die THS zu einer zukunftsträchtigen Methode in der Behandlung therapieresistenter Depression und Zwang.

Abstract

A substantial number of patients suffering from severe neuropsychiatric disorders do not respond to conventional therapeutic approaches. Results from functional neuroimaging research have led to novel putative strategies. Recently, one of these methods, deep brain stimulation (DBS) has been applied in selected patient with major depression and obsessive-compulsive disorder (OCD). In this article, reasons for the use of DBS in psychiatry are discussed. Also, the selection of different targets for major depression and OCD are described. First results have demonstrated that DBS might be able to modulate dysfunctional neural networks in both major depression and OCD. In the actual state of research, DBS can be considered as a valuable therapy option for therapy-resistant patients.

Schlüsselwörter

tiefe Hirnstimulation - Depression - Zwang

Key words

deep brain stimulation - depression - obsessive compulsive disorders

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