Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Psychiatry and Behavioral Sciences, University of Minnesota-Twin Cities, Minneapolis, MN, USA.
Brain Stimul. 2023 May-Jun;16(3):867-878. doi: 10.1016/j.brs.2023.05.011. Epub 2023 May 20.
Despite advances in the treatment of psychiatric diseases, currently available therapies do not provide sufficient and durable relief for as many as 30-40% of patients. Neuromodulation, including deep brain stimulation (DBS), has emerged as a potential therapy for persistent disabling disease, however it has not yet gained widespread adoption. In 2016, the American Society for Stereotactic and Functional Neurosurgery (ASSFN) convened a meeting with leaders in the field to discuss a roadmap for the path forward. A follow-up meeting in 2022 aimed to review the current state of the field and to identify critical barriers and milestones for progress.
The ASSFN convened a meeting on June 3, 2022 in Atlanta, Georgia and included leaders from the fields of neurology, neurosurgery, and psychiatry along with colleagues from industry, government, ethics, and law. The goal was to review the current state of the field, assess for advances or setbacks in the interim six years, and suggest a future path forward. The participants focused on five areas of interest: interdisciplinary engagement, regulatory pathways and trial design, disease biomarkers, ethics of psychiatric surgery, and resource allocation/prioritization. The proceedings are summarized here.
The field of surgical psychiatry has made significant progress since our last expert meeting. Although weakness and threats to the development of novel surgical therapies exist, the identified strengths and opportunities promise to move the field through methodically rigorous and biologically-based approaches. The experts agree that ethics, law, patient engagement, and multidisciplinary teams will be critical to any potential growth in this area.
尽管精神疾病的治疗方法取得了进展，但目前的治疗方法仍未能为多达 30-40%的患者提供充分和持久的缓解。神经调节，包括深部脑刺激（DBS），已成为治疗持续性致残性疾病的潜在疗法，但尚未得到广泛应用。2016 年，美国立体定向和功能神经外科学会（ASSFN）召集了一次会议，邀请该领域的领导者讨论前进的路线图。2022 年的后续会议旨在审查该领域的现状，并确定取得进展的关键障碍和里程碑。
ASSFN 于 2022 年 6 月 3 日在佐治亚州亚特兰大举行了一次会议，邀请了神经病学、神经外科学和精神病学领域的领导者以及来自工业界、政府、伦理和法律界的同事参加。会议的目的是审查该领域的现状，评估在过去六年中取得的进展或挫折，并为未来提出前进的道路。与会者重点关注五个感兴趣的领域：跨学科参与、监管途径和试验设计、疾病生物标志物、精神外科手术的伦理问题以及资源分配/优先化。会议的进程总结如下。
自我们上次专家会议以来，精神外科领域取得了重大进展。尽管新型手术疗法的发展存在弱点和威胁，但已确定的优势和机会有望通过系统严谨和基于生物学的方法推动该领域的发展。专家们一致认为，伦理、法律、患者参与和多学科团队对于该领域的任何潜在增长都将至关重要。
