Medihelp Clinic, Cartagena, Colombia.
Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia.
CNS Neurosci Ther. 2023 Jul;29(7):2010-2017. doi: 10.1111/cns.14156. Epub 2023 Mar 8.
Deep brain stimulation (DBS) is a surgical technique used to manage aggression in patients who do not improve despite the use of appropriate drug treatment.
The objective of this study is to assess the impact of DBS on aggressive behavior refractory to the pharmacological and behavioral treatment of patients with Intellectual Disabilities (ID).
A follow-up was conducted on a cohort of 12 patients with severe ID, undergoing DBS in posteromedial hypothalamic nuclei; evaluated with the Overt Aggression Scale (OAS), before the intervention, at 6, 12, and 18 months of medical follow-up.
After the surgical procedure, there was a significant reduction in the aggressiveness of patients in the follow-up medical evaluation at 6 months (t = 10.14; p < 0.01), 12 months (t = 14.06; p < 0.01), and 18 months (t = 15.34; p < 0.01), respect to the initial measurement; with a very large effect size (6 months: d = 2.71; 12 months: d = 3.75; 18 months: d = 4.10). From 12 months onward, emotional control stabilized and is sustained at 18 months (t = 1.24; p > 0.05).
DBS in posteromedial hypothalamic nuclei may be an effective treatment for the management of aggression in patients with ID refractory to pharmacological treatment.
深部脑刺激（DBS）是一种手术技术，用于治疗尽管使用了适当的药物治疗但仍未改善的攻击性患者。
本研究的目的是评估 DBS 对药物和行为治疗均无效的智力障碍（ID）患者的攻击性行为的影响。
对 12 名在后丘脑内侧核接受 DBS 的严重 ID 患者进行了随访；使用 Overt Aggression Scale（OAS）进行评估，在干预前、6、12 和 18 个月的医疗随访时进行评估。
手术后，患者在 6 个月（t=10.14；p<0.01）、12 个月（t=14.06；p<0.01）和 18 个月（t=15.34；p<0.01）的随访医疗评估中攻击性明显降低，与初始测量值相比，具有非常大的效应量（6 个月：d=2.71；12 个月：d=3.75；18 个月：d=4.10）。从 12 个月开始，情绪控制稳定并持续到 18 个月（t=1.24；p>0.05）。
后丘脑内侧核的 DBS 可能是治疗药物治疗无效的 ID 患者攻击性的有效方法。
