Eskandari Kiarash, Fattahi Mojdeh, Yazdanian Hassan, Haghparast Abbas
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neuroscience Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, P.O.Box 19615-1178, Tehran, Iran.
Neurochem Res. 2023 May;48(5):1255-1268. doi: 10.1007/s11064-022-03818-3. Epub 2022 Nov 29.
Addiction to psychostimulants significantly affects public health. Standard medical therapy is often not curative. Deep brain stimulation (DBS) is a promising treatment that has attracted much attention for addiction treatment in recent years. The present review aimed to systematically identify the positive and adverse effects of DBS in human and animal models to evaluate the feasibility of DBS as a treatment for psychostimulant abuse. The current study also examined the possible mechanisms underlying the therapeutic effects of DBS. In February 2022, a comprehensive search of four databases, including Web of Science, PubMed, Cochrane, and Scopus, was carried out to identify all reports that DBS was a treatment for psychostimulant addiction. The selected studies were extracted, summarized, and evaluated using the appropriate methodological quality assessment tools. The results indicated that DBS could reduce relapse and the desire for the drug in human and animal subjects without any severe side effects. The underlying mechanisms of DBS are complex and likely vary from region to region in terms of stimulation parameters and patterns. DBS seems a promising therapeutic option. However, clinical experiences are currently limited to several uncontrolled case reports. Further studies with controlled, double-blind designs are needed. In addition, more research on animals and humans is required to investigate the precise role of DBS and its mechanisms to achieve optimal stimulation parameters and develop new, less invasive methods.
对精神兴奋剂上瘾会严重影响公众健康。标准的药物治疗往往无法治愈。深部脑刺激（DBS）是一种很有前景的治疗方法，近年来在成瘾治疗方面备受关注。本综述旨在系统地确定DBS在人类和动物模型中的正面和负面影响，以评估DBS作为治疗精神兴奋剂滥用的可行性。当前的研究还探讨了DBS治疗效果的潜在机制。2022年2月，对四个数据库进行了全面检索，包括科学网、PubMed、Cochrane和Scopus，以确定所有关于DBS治疗精神兴奋剂成瘾的报告。使用适当的方法学质量评估工具对所选研究进行提取、总结和评估。结果表明，DBS可以减少人类和动物受试者的复发及对药物的渴望，且无任何严重副作用。DBS的潜在机制很复杂，可能因刺激参数和模式的不同而在不同脑区有所差异。DBS似乎是一种很有前景的治疗选择。然而，目前的临床经验仅限于几篇非对照病例报告。需要进一步开展对照双盲设计的研究。此外，还需要对动物和人类进行更多研究，以探究DBS的确切作用及其机制，从而实现最佳刺激参数，并开发新的、侵入性较小的方法。
