Fortschritte der Neurologie-Psychiatrie
-
Fortschr Neurol Psychiatr · May 2010
Review[Ethical aspects of deep brain stimulation in the treatment of psychiatric disorders].
Deep brain stimulation (DBS) is currently being tested as a possible treatment for treatment-refractory psychiatric disorders. Besides the hope set on this new therapeutic approach of DBS, there are at the same time doubts concerning the ethical acceptability in the treatment of individuals suffering from mental disorders. Taking the therapeutic benefit of DBS into account, the manuscript analyses ethical aspects of DBS application in psychiatry. ⋯ The ethical assessment of DBS considers therapeutic benefits, the method's minimal invasiveness and reversibility on the one hand, as well as surgery-related risks of DBS treatment, an insufficient data-base due to currently missing long-term studies and the possibility of as yet inestimable, potentially long-term effects on the patient's personality and self-determination on the other hand. The ethical balancing arrives at the conclusion that DBS may be considered as ultima ratio in the treatment of psychiatric disorders and should preferably be combined with psychosocial measures. Furthermore, a prospective scientific evaluation of the procedure should include a systematic investigation of personality changes.
-
For the treatment of Parkinson's disease invasive therapies have a long tradition. Deep brain stimulation is a well-established treatment option for the treatment of advanced Parkinson's disease with fluctuations. Further promising interventions for invasive therapy of Parkinson's disease are transplantation of foetal cells and stem cells, gene therapy and the use of duo-dopa and apomorhine.