Die tiefe Hirnstimulation bei psychiatrischen Erkrankungen

Deep brain stimulation (DBS), which is already established as an effective treatment for movement disorders, such as Parkinson’s disease, is increasingly being considered as a therapy option for mental diseases. Due to the increasing number of successful applications of DBS for otherwise therapy-resistant psychiatric diseases, DBS is becoming more and more of interest in fields of fundamental research as well as clinical care. However, the stimulation system is a medical product which has to be neurosurgically implanted and this fact is often used to draw certain analogies to earlier psychosurgical approaches in the era of Freeman. But, looking at the historical development of DBS, as is the aim of the present systematic and literature-based overview, it becomes obvious that DBS did not arise exclusively from the inglorious period of psychosurgery. In fact, two partly in parallel evolving lines of medical progress have contributed to the development of DBS as it is applied today. One of these lines is the use of lesional neurosurgical procedures, such as incision of capsules and cingulotomy, which in contrast to psychosurgical interventions in the era of Freeman, is aimed at subcortical structures and provides important basic knowledge for the choice of target points. In addition DBS is rooted in the application of an electrical charge with the goal to stimulate neuronal networks.