PMID- 35125136
OWN - NLM
STAT- MEDLINE
DCOM- 20220208
LR  - 20220628
IS  - 1525-1403 (Electronic)
IS  - 1094-7159 (Linking)
VI  - 25
IP  - 2
DP  - 2022 Feb
TI  - Safety and Feasibility of Nucleus Accumbens Surgery for Drug Addiction: A 
      Systematic Review.
PG  - 171-184
LID - S1094-7159(21)06974-9 [pii]
LID - 10.1111/ner.13348 [doi]
AB  - BACKGROUND: Substance addiction encompasses the incapacity to discontinue urgent 
      drug use; many severely disabled patients might be considered appropriate 
      candidates for surgery due to the high rates of relapse despite conservative 
      treatment. A crucial finding in the brain of these patients is increased 
      extracellular concentrations of dopamine in the nucleus accumbens (NAcc). 
      OBJECTIVES: To determine the efficacy and safety of NAcc surgery for the 
      treatment of substance dependence. MATERIALS AND METHODS: Adhering to PRISMA 
      guidelines, we performed a systematic review to identify all original studies in 
      which NAcc surgery was performed to treat relapsing drug addiction with a minimum 
      follow-up of six months. From database inception to April 10, 2020, we searched 
      PubMed, Scopus, and LILACS. Two reviewers independently selected studies and 
      extracted data. The main outcome was the relapse rate. The GRADE methods were 
      applied to evaluate the quality of evidence. This study was registered with 
      PROSPERO CRD42020177054. RESULTS: Fifteen studies involving 359 participants met 
      inclusion criteria; eight (56%) included NAcc deep brain stimulation (DBS) in 13 
      patients with addiction for alcohol (N = 6, 46.1%), opioid (N = 4, 30.7%), and 
      nicotine (N = 3, 15.3%); seven studies (N = 346, 44%) performed NAcc 
      radiofrequency (RF) ablation for opioid (N = 334) and alcohol (N = 12) 
      dependence. Relapse rates were 38.4% for DBS and 39% for RF ablation. 
      CONCLUSIONS: Despite available studies reporting a benefit in the treatment of 
      drug addictions with NAcc surgery, this systematic review stresses the need for 
      carefully planned prospective studies in order to further address the efficacy 
      and indications.
CI  - Copyright (c) 2021. Published by Elsevier Inc.
FAU - Navarro, Paula Alejandra
AU  - Navarro PA
AD  - Grupo de investigacion NEMOD, division de neurocirugia funcional, departamento de 
      neurocirugia, clinica FOSCAL, Universidad Autonoma de Bucaramanga, Bucaramanga, 
      Colombia.
FAU - Paranhos, Thiago
AU  - Paranhos T
AD  - School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
FAU - Lovo, Eduardo
AU  - Lovo E
AD  - Centro Internacional de Cancer Hospital de Diagnostico, San Salvador, El 
      Salvador.
FAU - De Oliveira-Souza, Ricardo
AU  - De Oliveira-Souza R
AD  - Department of Neurology and Neuropsychiatry, D'Or Institute for Research and 
      Education, Rio de Janeiro, Brazil.
FAU - Gorgulho, Alessandra A
AU  - Gorgulho AA
AD  - NeuroSapiens and Rede D'Or Sao Luiz, Sao Paulo, Brazil.
FAU - De Salles, Antonio
AU  - De Salles A
AD  - NeuroSapiens and Rede D'Or Sao Luiz, Sao Paulo, Brazil.
FAU - Lopez, William Omar Contreras
AU  - Lopez WOC
AD  - Grupo de investigacion NEMOD, division de neurocirugia funcional, departamento de 
      neurocirugia, clinica FOSCAL, Universidad Autonoma de Bucaramanga, Bucaramanga, 
      Colombia. Electronic address: wcontreras127@unab.edu.co.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Neuromodulation
JT  - Neuromodulation : journal of the International Neuromodulation Society
JID - 9804159
SB  - IM
MH  - *Deep Brain Stimulation
MH  - Feasibility Studies
MH  - Humans
MH  - Nucleus Accumbens/surgery
MH  - Prospective Studies
MH  - *Substance-Related Disorders/therapy
OTO - NOTNLM
OT  - Addictive
OT  - behavior
OT  - deep brain stimulation
OT  - neurosurgical procedures
OT  - nucleus accumbens
OT  - substance-related disorders
EDAT- 2022/02/08 06:00
MHDA- 2022/02/09 06:00
CRDT- 2022/02/07 05:24
PHST- 2020/08/17 00:00 [received]
PHST- 2020/12/07 00:00 [revised]
PHST- 2020/12/08 00:00 [accepted]
PHST- 2022/02/07 05:24 [entrez]
PHST- 2022/02/08 06:00 [pubmed]
PHST- 2022/02/09 06:00 [medline]
AID - S1094-7159(21)06974-9 [pii]
AID - 10.1111/ner.13348 [doi]
PST - ppublish
SO  - Neuromodulation. 2022 Feb;25(2):171-184. doi: 10.1111/ner.13348.