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Neurosurgical treatment for addiction: lessons from an untold story in China and a path forward

National Science Review 2020年第3期7卷 702-712页

作者： Shuo Ma Chencheng Zhang Ti-fei Yuan Douglas Steele valerie voon Bomin Sun Department of Functional Neurosurgery Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health CenterShanghai Jiao Tong University School of Medicine Co-innovation Center of Neuroregeneration Nantong University Division of Imaging Science and Technology Medical School University of Dundee Department of Psychiatry University of Cambridge

Addiction is a major public-health crisis associated with significant disability and mortality. Although various pharmacological and behavioral treatments are currently available, the clinical efficacy of these treatments is limited. Given this situation, there is a growing interest in finding an effective neurosurgical treatment for addiction. First, we discuss the use of ablative surgery in treating addiction. We focus on the rise and fall of nucleus accumbens ablation for addiction in China. Subsequently, we review recent studies that have explored the efficacy and safety of deep-brain-stimulation treatment for addiction. We conclude that neurosurgical procedures, particularly deep-brain stimulation, have a potentially valuable role in the management of otherwise intractable addictive disorders. Larger well-controlled clinical trials, however, are needed to assess clinical efficacy and safety. We end by discussing several key issues involved in this clinical field and identifying some areas of progress.

关键词： drug addiction psychosurgery ablative surgery deep-brain stimulation medical ethics

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Deep brain stimulation for Tourette’s syndrome

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Translational Neurodegeneration 2020年第1期9卷 20-38页

作者： Wenying Xu Chencheng Zhang Wissam Deeb Bhavana Patel Yiwen Wu valerie voon Michael S.Okun Bomin Sun Department of Functional Neurosurgery Ruijin HospitalShanghai Jiao Tong University School of MedicineRuijin Hospital197 Ruijin Er RoadShanghai 200025China Norman Fixel Institute for Neurological Diseases Department of NeurologyCollege of MedicineUniversity of FloridaGainesvilleFL 32608USA Department of Neurology&Institute of Neurology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Psychiatry University of CambridgeCambridgeUK

Tourette syndrome(TS)is a childhood-onset neuropsychiatric disorder characterized by the presence of multiple motor and vocal *** usually co-occurs with one or multiple psychiatric *** behavioral and pharmacological treatments for TS are available,some patients do not respond to the available *** these patients,TS is a severe,chronic,and disabling *** recent years,deep brain stimulation(DBS)of basal ganglia-thalamocortical networks has emerged as a promising intervention for refractory TS with or without psychiatric *** major challenges need to be addressed to move the field of DBS treatment for TS forward:(1)patient and DBS target selection,(2)ethical concerns with treating pediatric patients,and(3)DBS treatment optimization and improvement of individual patient outcomes(motor and phonic tics,as well as functioning and quality of life).The Tourette Association of America and the American Academy of Neurology have recently released their recommendations regarding surgical treatment for refractory ***,we describe the challenges,advancements,and promises of the use of DBS in the treatment of *** summarize the results of clinical studies and discuss the ethical issues involved in treating pediatric *** aim is to provide a better understanding of the feasibility,safety,selection process,and clinical effectiveness of DBS treatment for select cases of severe and medically intractable TS.

关键词： Tourette syndrome Deep brain stimulation Capsulotomy Adaptive close loop Connectivity

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Paired associative stimulation influencing cognitive domains: inhibition and goaldirected control

Paired associative stimulation influencing cognitive domains...

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第二十二届全国心理学学术会议

作者： valerie voon Institute of Science and Technology for Brain Inspired Intelligence Fudan University

Cortical paired associative stimulation (PAS) is a transcranial magnetic stimulation protocol in which paired pulses from two different coils can influence long-term plasticity or depression. PAS has been most commonly studied within the motor domain. Recent studies have shown the capacity for PAS to modify behavioural outcomes. Here I will discuss two PAS studies. First, we targeted inhibitory cortical networks which improved

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Presurgical structural imaging and clinical outcome in combined bed nucleus of the stria terminalis-nucleus accumbens deep brain stimulation for treatment-resistant depression

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General Psychiatry 2024年第3期37卷 412-421页

作者： Fengting Wang Lulin Dai Tao Wang Yingying Zhang Yuhan Wang Yijie Zhao Yixin Pan Liuguan Bian Dianyou Li Shikun Zhan Yijie Lai valerie voon Bomin Sun Department of Neurosurgery Shanghai Jiao Tong University Medical School Affiliated Ruijin HospitalShanghaiChina Department of Psychiatry Zhejiang University School of Medicine Sir Run Run Shaw HospitalHangzhouChina Fudan University Institute of Science and Technology for Brain-inspired Intelligence ShanghaiChina Clinical Research Center for Mental Disorders Shanghai Pudong New Area Mental Health CenterShanghaiChina Department of Psychiatry University of CambridgeCambridgeUK

Background Structural imaging holds great potential for precise targeting and stimulation for deep brain stimulation(DBS).The anatomical information it provides may serve as potential biomarkers for predicting the efficacy of DBS in treatment-resistant depression(TRD).Aims The primary aim is to identify preoperative imaging biomarkers that correlate with the efficacy of DBS in patients with *** Preoperative imaging parameters were estimated and correlated with the 6-month clinical outcome of patients with TRD receiving combined bed nucleus of the stria terminalis(BNST)-nucleus accumbens(NAc)*** matter(WM)properties were extracted and compared between the response/non-response and remission/non-remission *** connectome was constructed and analysed using graph *** of the volume of activated tissue(VAT)to the main modulating tracts were also estimated to evaluate the *** Differences in fibre bundle properties of tracts,including superior thalamic radiation and reticulospinal tract,were observed between the remission and nonremission *** of the centre of the VAT to tracts connecting the ventral tegmental area and the anterior limb of internal capsule on the left side varied between the remission and non-remission groups(p=0.010,t=3.07).The normalised clustering coefficient(γ)and the small-world property(σ)in graph analysis correlated with the symptom improvement after the correction of *** Presurgical structural alterations in WM tracts connecting the frontal area with subcortical regions,as well as the distance of the VAT to the modulating tracts,may influence the clinical outcome of BNST-NAc *** findings provide potential imaging biomarkers for the DBS treatment for patients with TRD.

关键词： stimulation alterations treatment

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