School of Medicine, Koc University, Istanbul, Turkey.
Department of Neurosurgery, Korle Bu Teaching Hospital, Accra, Ghana.
Neurosurg Rev. 2024 Aug 26;47(1):479. doi: 10.1007/s10143-024-02746-w.
Deep Brain Stimulation (DBS) has emerged as a revolutionary neurosurgical technique with significant implications for the treatment of various neuropsychiatric disorders. Initially developed for movement disorders like Parkinson's disease, DBS has expanded to psychiatric conditions such as obsessive-compulsive disorder, depression, anorexia nervosa, dystonia, essential tremor, and Tourette's syndrome. This paper explores the clinical efficacy and ethical considerations of DBS in treating these disorders. While DBS has shown substantial promise in alleviating symptoms and improving quality of life, it raises ethical challenges, including issues of informed consent, patient selection, long-term management, and equitable access to treatment. The irreversible nature of DBS, potential adverse effects, and the high cost of the procedure necessitate a rigorous ethical framework to guide its application. The ongoing evolution of neuromodulation requires continuous ethical analysis and the development of guidelines to ensure that DBS is used responsibly and equitably across different patient populations. This paper underscores the need for a balanced approach that integrates clinical efficacy with ethical considerations to optimize patient outcomes and ensure sustainable practice.
脑深部电刺激(DBS)作为一种革命性的神经外科技术,在治疗各种神经精神疾病方面具有重要意义。最初开发用于治疗帕金森病等运动障碍,DBS 已扩展到强迫症、抑郁症、神经性厌食症、肌张力障碍、特发性震颤和妥瑞氏综合征等精神疾病。本文探讨了 DBS 在治疗这些疾病中的临床疗效和伦理考虑。虽然 DBS 在缓解症状和提高生活质量方面显示出巨大的潜力,但它也带来了伦理挑战,包括知情同意、患者选择、长期管理以及公平获得治疗等问题。DBS 的不可逆性、潜在的不良反应以及手术的高昂费用都需要一个严格的伦理框架来指导其应用。神经调节的不断发展需要进行持续的伦理分析和制定指南,以确保 DBS 在不同患者群体中得到负责任和公平的应用。本文强调需要采取一种平衡的方法,将临床疗效与伦理考虑相结合,以优化患者的治疗效果,并确保可持续的实践。