PMID- 37245316
OWN - NLM
STAT- MEDLINE
DCOM- 20230612
LR  - 20231122
IS  - 1879-1379 (Electronic)
IS  - 0022-3956 (Linking)
VI  - 163
DP  - 2023 Jul
TI  - Long-term outcomes of deep brain stimulation for treatment-resistant 
      schizophrenia: Exploring potential targets.
PG  - 296-304
LID - S0022-3956(23)00233-9 [pii]
LID - 10.1016/j.jpsychires.2023.05.056 [doi]
AB  - BACKGROUND: Schizophrenia is a complex and disabling disorder. Around 30% of 
      patients have treatment-resistant schizophrenia (TRS). OBJECTIVE: This study 
      summarizes the outcomes after three years follow-up of the first series of 
      patients with TRS treated with deep brain stimulation (DBS) and discuss surgical, 
      clinical and imaging analysis. METHODS: Eight patients with TRS treated with DBS 
      in the nucleus accumbens (NAcc) or the subgenual cingulate gyrus (SCG) were 
      included. Symptoms were rated with the PANSS scale and normalized using the 
      illness density index (IDI). A reduction in IDI-PANSS of >/=25% compared to 
      baseline was the criterion of good response. The volume of activated tissue was 
      calculated to perform a connectomic analysis for each patient. An estimation of 
      the tracts and cortical areas modulated was generated. RESULTS: Five women and 
      three men were analyzed. After 3 years' follow-up, positive symptoms improved in 
      50% of the SCG group and 75% of the NAcc group (p = 0.06), and general symptoms 
      improved in 25% and 50% respectively (p = 0.06). The SCG group showed activation 
      of the cingulate bundle and modulation of orbitofrontal and frontomesial regions; 
      in contrast, the NAcc group showed activation of the ventral tegmental area 
      projections pathway and modulation of regions associated with the "default mode 
      network" (precuneus) and Brodmann areas 19 and 20. CONCLUSIONS: These results 
      showed a trend toward improvement for positive and general symptoms in patients 
      with TRS treated with DBS. The connectomic analysis will help us understand the 
      interaction of this treatment with the disease to pursue future trial designs.
CI  - Copyright (c) 2023 Elsevier Ltd. All rights reserved.
FAU - Aibar-Duran, Juan Angel
AU  - Aibar-Duran JA
AD  - Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Universitat Autonoma de 
      Barcelona (UAB), Barcelona, Spain.
FAU - Corripio Collado, Iluminada
AU  - Corripio Collado I
AD  - Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Centro de Investigacion 
      Biomedica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
FAU - Roldan Bejarano, Alexandra
AU  - Roldan Bejarano A
AD  - Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Centro de Investigacion 
      Biomedica en Red de Salud Mental (CIBERSAM), Barcelona, Spain. Electronic 
      address: aroldanb@santpau.cat.
FAU - Sanchez Nevado, Raquel
AU  - Sanchez Nevado R
AD  - Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Universitat Autonoma de 
      Barcelona (UAB), Barcelona, Spain.
FAU - Aracil Bolanos, Ignacio
AU  - Aracil Bolanos I
AD  - Deparment of Neurology, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Universitat Autonoma de 
      Barcelona (UAB), Barcelona, Spain.
FAU - Garcia-Cornet, Julia
AU  - Garcia-Cornet J
AD  - Ingeniering imaging and Signaling, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Universitat Autonoma de 
      Barcelona (UAB), Barcelona, Spain.
FAU - Alonso-Solis, Anna
AU  - Alonso-Solis A
AD  - Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Centro de Investigacion 
      Biomedica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
FAU - Grasa Bello, Eva Ma
AU  - Grasa Bello EM
AD  - Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Centro de Investigacion 
      Biomedica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
FAU - de Quintana Schmidt, Cristian
AU  - de Quintana Schmidt C
AD  - Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Universitat Autonoma de 
      Barcelona (UAB), Barcelona, Spain.
FAU - Munoz Hernandez, Fernando
AU  - Munoz Hernandez F
AD  - Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Universitat Autonoma de 
      Barcelona (UAB), Barcelona, Spain.
FAU - Molet Teixido, Joan
AU  - Molet Teixido J
AD  - Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Universitat Autonoma de 
      Barcelona (UAB), Barcelona, Spain.
FAU - Rodriguez, Rodrigo Rodriguez
AU  - Rodriguez RR
AD  - Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Institut 
      d'Investigacio Biomedica Sant Pau (IIB-Sant Pau), Universitat Autonoma de 
      Barcelona (UAB), Barcelona, Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230518
PL  - England
TA  - J Psychiatr Res
JT  - Journal of psychiatric research
JID - 0376331
SB  - IM
MH  - Male
MH  - Humans
MH  - Female
MH  - *Schizophrenia/therapy/etiology
MH  - *Deep Brain Stimulation/methods
MH  - Schizophrenia, Treatment-Resistant
MH  - Nucleus Accumbens/diagnostic imaging
MH  - Parietal Lobe
OTO - NOTNLM
OT  - Deep brain stimulation
OT  - Nucleus accumbens
OT  - Subgenual cingulate gyrus
OT  - Tractography-activation model
OT  - Treatment-resistant schizophrenia
COIS- Declaration of competing interest Dr. Aibar has been consultant for Medtronic. 
      All the other authors have no conflict of interest to disclose.
EDAT- 2023/05/29 00:42
MHDA- 2023/06/12 06:42
CRDT- 2023/05/28 18:02
PHST- 2023/03/21 00:00 [received]
PHST- 2023/05/03 00:00 [revised]
PHST- 2023/05/15 00:00 [accepted]
PHST- 2023/06/12 06:42 [medline]
PHST- 2023/05/29 00:42 [pubmed]
PHST- 2023/05/28 18:02 [entrez]
AID - S0022-3956(23)00233-9 [pii]
AID - 10.1016/j.jpsychires.2023.05.056 [doi]
PST - ppublish
SO  - J Psychiatr Res. 2023 Jul;163:296-304. doi: 10.1016/j.jpsychires.2023.05.056. 
      Epub 2023 May 18.