Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders

Bart Nuttin, Hemmings Wu, Helen Mayberg, Marwan Hariz, Loes Gabriëls, Thorsten Galert, Reinhard Merkel, Cynthia Kubu, Osvaldo Vilela-Filho, Keith Matthews, Takaomi Taira, Andres M. Lozano, Gastoń Schechtmann, Paresh Doshi, Giovanni Broggi, Jean Reǵis, Ahmed Alkhani, Bomin Sun, Sam Eljamel, Michael Schulder & 14 others Michael Kaplitt, Emad Eskandar, Ali Rezai, Joachim K. Krauss, Paulien Hilven, Rick Schuurman, Pedro Ruiz, Jin Woo Chang, Paul Cosyns, Nir Lipsman, Juergen Voges, Rees Cosgrove, Yongjie Li, Thomas Schlaepfer

Research output: Contribution to journalArticle

73 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1003-1008
Number of pages6
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume85
Issue number9
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Neurosurgery
Psychiatry
Consensus
Guidelines
Brain Diseases
Neurosurgical Procedures
Deep Brain Stimulation
Obsessive-Compulsive Disorder
Patient Safety
Randomized Controlled Trials
Research Personnel
Depression
Delivery of Health Care
Brain

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Surgery
  • Arts and Humanities (miscellaneous)

Cite this

Nuttin, B., Wu, H., Mayberg, H., Hariz, M., Gabriëls, L., Galert, T., ... Schlaepfer, T. (2014). Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders. Journal of Neurology, Neurosurgery and Psychiatry, 85(9), 1003-1008. https://doi.org/10.1136/jnnp-2013-306580

Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders. / 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, Gastoń; Doshi, Paresh; Broggi, Giovanni; Reǵis, Jean; Alkhani, Ahmed; Sun, Bomin; Eljamel, Sam; Schulder, Michael; Kaplitt, Michael; Eskandar, Emad; 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.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 85, No. 9, 01.01.2014, p. 1003-1008.

Research output: Contribution to journalArticle

Nuttin, B, Wu, H, Mayberg, H, Hariz, M, Gabriëls, L, Galert, T, Merkel, R, Kubu, C, Vilela-Filho, O, Matthews, K, Taira, T, Lozano, AM, Schechtmann, G, Doshi, P, Broggi, G, Reǵis, J, Alkhani, A, Sun, B, Eljamel, S, Schulder, M, Kaplitt, M, Eskandar, E, Rezai, A, Krauss, JK, Hilven, P, Schuurman, R, Ruiz, P, Chang, JW, Cosyns, P, Lipsman, N, Voges, J, Cosgrove, R, Li, Y & Schlaepfer, T 2014, 'Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders', Journal of Neurology, Neurosurgery and Psychiatry, vol. 85, no. 9, pp. 1003-1008. https://doi.org/10.1136/jnnp-2013-306580
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, Gastoń ; Doshi, Paresh ; Broggi, Giovanni ; Reǵis, Jean ; Alkhani, Ahmed ; Sun, Bomin ; Eljamel, Sam ; Schulder, Michael ; Kaplitt, Michael ; Eskandar, Emad ; 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. / Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders. In: Journal of Neurology, Neurosurgery and Psychiatry. 2014 ; Vol. 85, No. 9. pp. 1003-1008.
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AU - Nuttin, Bart

AU - Wu, Hemmings

AU - Mayberg, Helen

AU - Hariz, Marwan

AU - Gabriëls, Loes

AU - Galert, Thorsten

AU - Merkel, Reinhard

AU - Kubu, Cynthia

AU - Vilela-Filho, Osvaldo

AU - Matthews, Keith

AU - Taira, Takaomi

AU - Lozano, Andres M.

AU - Schechtmann, Gastoń

AU - Doshi, Paresh

AU - Broggi, Giovanni

AU - Reǵis, Jean

AU - Alkhani, Ahmed

AU - Sun, Bomin

AU - Eljamel, Sam

AU - Schulder, Michael

AU - Kaplitt, Michael

AU - Eskandar, Emad

AU - Rezai, Ali

AU - Krauss, Joachim K.

AU - Hilven, Paulien

AU - Schuurman, Rick

AU - Ruiz, Pedro

AU - Chang, Jin Woo

AU - Cosyns, Paul

AU - Lipsman, Nir

AU - Voges, Juergen

AU - Cosgrove, Rees

AU - Li, Yongjie

AU - Schlaepfer, Thomas

PY - 2014/1/1

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