• Ausaf A Bari, Charles B Mikell, Aviva Abosch, Sharona Ben-Haim, Robert J Buchanan, Allen W Burton, Stephen Carcieri, G Rees Cosgrove, Pierre-Francois D'Haese, Zafiris Jeffrey Daskalakis, Emad N Eskandar, Jason L Gerrard, Wayne K Goodman, Benjamin David Greenberg, Robert E Gross, Clement Hamani, Kiss Zelma H T ZHT Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada., Peter Konrad, Brian H Kopell, Lothar Krinke, Jean-Philippe Langevin, Andres M Lozano, Donald Malone, Helen S Mayberg, Jonathan P Miller, Parag G Patil, DeLea Peichel, Erika A Petersen, Ali R Rezai, R Mark Richardson, Patricio Riva-Posse, Tejas Sankar, Jason M Schwalb, Helen Blair Simpson, Konstantin Slavin, Paul H Stypulkowski, Tor Tosteson, Peter Warnke, Jon T Willie, Kareem A Zaghloul, Joseph S Neimat, Nader Pouratian, and Sameer A Sheth.
• Department of Neurosurgery, University of California Los Angeles Medical Center, Los Angeles, California, USA.
• J. Neurol. Neurosurg. Psychiatr. 2018 Aug 1; 89 (8): 886-896.

ObjectiveRefractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive-compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016.DesignHere we summarise the proceedings of the workshop. Participants discussed a number of issues of importance to the community. First, we discussed how to interpret results from the recent pivotal trials of DBS for OCD and depression. We then reviewed what can be learnt from lesions and closed-loop neurostimulation. Subsequently, representatives from the National Institutes of Health, the Food and Drug Administration and industry discussed their views on neuromodulation for psychiatric disorders. In particular, these third parties discussed their criteria for moving forward with new trials. Finally, we discussed the best way of confirming safety and efficacy of these therapies, including registries and clinical trial design. We close by discussing next steps in the journey to new neuromodulatory therapies for these devastating illnesses.ConclusionInterest and motivation remain strong for deep brain stimulation for psychiatric disease. Progress will require coordinated efforts by all stakeholders.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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