Citation

Peeters S, Skoch J, Holt H, Mubita L, Choudhary EA, Vadivelu KP, Gilbert DL, Wu SW, Keebaugh AC, Air E, Vadivelu S. Pediatr. Neurosurg. 2018; 53(2): 71-80.

Affiliation

Division of Pediatric Neurosurgery and Neurology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Copyright

(Copyright © 2018, Karger Publishers)

DOI

10.1159/000485385

PMID

29402877

Abstract

BACKGROUND: Secondary self-injurious behavior (SSIB) is underreported and predominantly not associated with suicide. In both adults and children, SSIB can cause intractable self-harm and is associated with a variety of clinical disorders, particularly those involving dysfunctional motor control.

METHODS: We performed a literature review evaluating the clinical efficacy of deep-brain stimulation (DBS) as modulating SSIB observations and review current progress in preclinical SSIB animal studies.

RESULTS: Neuromodulation is an effective therapeutic option for several movement disorders. Interestingly, this approach is emerging as a potentially effective treatment for movement disorder-associated SSIB (secondary); however, it is important to understand the neuroanatomy, clinical appraisal, and outcome data when considering surgical therapy for SSIB.

CONCLUSION: The current review examines the literature encompassing animal models and human case studies while identifying existing hypotheses from cytoarchitectonic-based targeting to neurotransmitter-based pathways. This review also highlights the need for awareness of an underrecognized pathology that may be amenable to DBS.

© 2018 S. Karger AG, Basel.

Language: en

Keywords

Basal ganglia; Deep-brain stimulation; Movement disorder; Neuromodulation; Pallidotomy; Self-injury