Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders
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Author
Nuttin, Bart
Wu, Hemmings
Mayberg, Helen
Hariz, Marwan
Gabriëls, Loes
Galert, Thorsten
Merkel, Reinhard
Kubu, Cynthia
Vilela-Filho, Osvaldo
Matthews, Keith
Taira, Takaomi
Lozano, Andres M
Schechtmann, Gastón
Doshi, Paresh
Broggi, Giovanni
Régis, Jean
Alkhani, Ahmed
Sun, Bomin
Eljamel, Sam
Schulder, Michael
Kaplitt, Michael
Rezai, Ali
Krauss, Joachim K
Hilven, Paulien
Schuurman, Rick
Ruiz, Pedro
Chang, Jin Woo
Cosyns, Paul
Lipsman, Nir
Voges, Juergen
Cosgrove, Rees
Li, Yongjie
Schlaepfer, Thomas
Note: Order does not necessarily reflect citation order of authors.
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https://doi.org/10.1136/jnnp-2013-306580Metadata
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Nuttin, B., H. Wu, H. Mayberg, M. Hariz, L. Gabriëls, T. Galert, R. Merkel, et al. 2014. “Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders.” Journal of Neurology, Neurosurgery, and Psychiatry 85 (9): 1003-1008. doi:10.1136/jnnp-2013-306580. http://dx.doi.org/10.1136/jnnp-2013-306580.Abstract
Background: For patients with psychiatric illnesses remaining refractory to ‘standard’ therapies, neurosurgical procedures may be considered. Guidelines for safe and ethical conduct of such procedures have previously and independently been proposed by various local and regional expert groups. Methods: To expand on these earlier documents, representative members of continental and international psychiatric and neurosurgical societies, joined efforts to further elaborate and adopt a pragmatic worldwide set of guidelines. These are intended to address a broad range of neuropsychiatric disorders, brain targets and neurosurgical techniques, taking into account cultural and social heterogeneities of healthcare environments. Findings: The proposed consensus document highlights that, while stereotactic ablative procedures such as cingulotomy and capsulotomy for depression and obsessive-compulsive disorder are considered ‘established’ in some countries, they still lack level I evidence. Further, it is noted that deep brain stimulation in any brain target hitherto tried, and for any psychiatric or behavioural disorder, still remains at an investigational stage. Researchers are encouraged to design randomised controlled trials, based on scientific and data-driven rationales for disease and brain target selection. Experienced multidisciplinary teams are a mandatory requirement for the safe and ethical conduct of any psychiatric neurosurgery, ensuring documented refractoriness of patients, proper consent procedures that respect patient's capacity and autonomy, multifaceted preoperative as well as postoperative long-term follow-up evaluation, and reporting of effects and side effects for all patients. Interpretation This consensus document on ethical and scientific conduct of psychiatric surgery worldwide is designed to enhance patient safety.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145431/pdf/Terms of Use
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http://nrs.harvard.edu/urn-3:HUL.InstRepos:12987384
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