Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, United States.
Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States.
Brain Stimul. 2023 Jul-Aug;16(4):990-998. doi: 10.1016/j.brs.2023.06.007. Epub 2023 Jun 15.
There has been substantial controversy in the neuroethics literature regarding the extent to which deep brain stimulation (DBS) impacts dimensions of personality, mood, and behavior.
OBJECTIVE/HYPOTHESIS: Despite extensive debate in the theoretical literature, there remains a paucity of empirical data available to support or refute claims related to the psychosocial changes following DBS.
A mixed-methods approach was used to examine the perspectives of patients who underwent DBS regarding changes to their personality, authenticity, autonomy, risk-taking, and overall quality of life.
Patients (n = 21) who were enrolled in adaptive DBS trials for Parkinson's disease, essential tremor, obsessive-compulsive disorder, Tourette's syndrome, or dystonia participated. Qualitative data revealed that participants, in general, reported positive experiences with alterations in what was described as 'personality, mood, and behavior changes.' The majority of participants reported increases in quality of life. No participants reported 'regretting the decision to undergo DBS.'
CONCLUSION(S): The findings from this patient sample do not support the narrative that DBS results in substantial adverse changes to dimensions of personality, mood, and behavior. Changes reported as "negative" or "undesired" were few in number, and transient in nature.
在神经伦理学文献中,关于深度脑刺激(DBS)在多大程度上影响人格、情绪和行为等方面存在着很大的争议。
目的/假设:尽管在理论文献中进行了广泛的辩论,但仍然缺乏支持或反驳与 DBS 后心理社会变化相关的声称的经验数据。
采用混合方法研究,探讨接受 DBS 的患者对其人格、真实性、自主性、冒险行为和整体生活质量变化的看法。
纳入了帕金森病、特发性震颤、强迫症、妥瑞氏综合征或肌张力障碍的适应性 DBS 试验的患者(n=21)参与了研究。定性数据分析显示,大多数参与者表示对所谓的“人格、情绪和行为变化”的改变有积极的体验。大多数参与者报告生活质量提高。没有参与者报告“后悔接受 DBS 治疗”。
本患者样本的研究结果不支持 DBS 会导致人格、情绪和行为等方面出现实质性的不良变化的说法。报告的“负面”或“不理想”的变化数量较少,且是暂时的。