Citation

Müller S, Riedmüller R, van Oosterhout A. Front. Integr. Neurosci. 2015; 9(APRIL).

Copyright

(Copyright © 2015, Frontiers Research Foundation)

DOI

10.3389/fnint.2015.00027

PMID

unavailable

Abstract

In the wake of deep brain stimulation (DBS) development, ablative neurosurgical procedures are seeing a comeback, although they had been discredited and nearly completely abandoned in the 1970s because of their unethical practice. Modern stereotactic ablative procedures as thermal or radiofrequency ablation, and particularly radiosurgery (e.g., Gamma Knife) are much safer than the historical procedures, so that a re-evaluation of this technique is required. The different approaches of modern psychiatric neurosurgery refer to different paradigms: microsurgical ablative procedures is based on the paradigm 'quick fix,' radiosurgery on the paradigm 'minimal-invasiveness,' and DBS on the paradigm 'adjustability.' From a mere medical perspective, none of the procedures is absolutely superior; rather, they have different profiles of advantages and disadvantages. Therefore, individual factors are crucial in decision-making, particularly the patients' social situation, individual preferences, and individual attitudes. The different approaches are not only rivals, but also enriching mutually. DBS is preferable for exploring new targets, which may become candidates for ablative microsurgery or radiosurgery. © 2015 Müller, Riedmüller and van Oosterhout.

Language: en

Keywords

human; suicide; depression; anorexia nervosa; mood disorder; emotional disorder; epilepsy; fatigue; pancreatitis; weight reduction; headache; somnolence; vertigo; anxiety disorder; panic; confusion; seizure; neurosurgery; weight gain; delirium; fever; disorientation; mania; hypomania; apathy; brain hemorrhage; brain hematoma; obsessive compulsive disorder; concentration loss; intermethod comparison; urine incontinence; bradycardia; lethargy; treatment response; hypophosphatemia; brain depth stimulation; capsulotomy; dysesthesia; Article; hypokalemia; incontinence; psychosurgery; patient decision making; visual disorder; microsurgery; surgical risk; adverse outcome; DBS; hemiplegia; minimally invasive surgery; ablation therapy; air embolism; gamma knife radiosurgery; Ablative neurosurgery; Capsulotomy; Cingulotomy; Gamma knife; Neuroethics; Psychiatric neurosurgery; radiofrequency ablation; Radiosurgery