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Chapter 16 - Neurosurgery for Mental Disorder

Published online by Cambridge University Press:  27 June 2019

By
Keith Matthews  and
Christine A Matthews
Edited by
I. Nicol Ferrier  and
Jonathan Waite
I. Nicol Ferrier
Affiliation:
University of Newcastle upon Tyne
Jonathan Waite
Affiliation:
University of Nottingham
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Summary

There is a general recognition that, notwithstanding recent advances and improvements in the targeting and delivery of ECT, within routine clinical practice there continue to be a significant minority of patients who are either not helped by, or are unable to tolerate, ECT (Scottish Electroconvulsive Therapy Accreditation Network, 2016). Failure to sustain a useful antidepressant effect, even with diligent attention to all available maintenance measures, remains a particular clinical challenge. In the previous edition of The ECT Handbook (Waite & Easton, 2013), emerging evidence to support the use of different brain stimulation therapies was reviewed. With repetitive Transcranial Magnetic Stimulation (rTMS) now addressed within a separate chapter (Chapter 15), here we consider the present status of three distinct forms of neurosurgical intervention: vagus nerve stimulation (VNS), deep brain stimulation (DBS) and stereotactic ablative (lesion generation) surgery. Each of these therapeutic approaches are also addressed within the 2017 Royal College of Psychiatrists’ Position Statements on Neurosurgery for Mental Disorders (NMD) (RCPsych CERT 05/17, 2017).

Type
Chapter
Information
The ECT Handbook , pp. 140 - 148
Publisher: Cambridge University Press
Print publication year: 2019

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References

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