Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders

Bart Nuttin (Lead / Corresponding author), Hemmings Wu, Helen Mayberg, Marwan Hariz, Loes Gabriëls, Thorsten Galert, Reinhard Merkel, Cynthia Kubu, Osvaldo Vilela-Filho, Keith Matthews, Takaomi Taira, Andres M. Lozano, Gastón Schechtmann, Paresh Doshi, Giovanni Broggi, Jean Régis, Ahmed Alkhani, Bomin Sun, Sam Eljamel, Michael Schulder & 14 others Michael Kaplitt, Emad Eskandar, Ali Rezai, Joachim K. Krauss, Paulien Hilven, Rick Schuurman, Pedro Ruiz, Jin Woo Chang, Paul Cosyns, Nir Lipsman, Juergen Voges, Rees Cosgrove, Yongjie Li, Thomas Schlaepfer

    Research output: Contribution to journalArticle

    73 Citations (Scopus)
    67 Downloads (Pure)

    Abstract

    Background: For patients with psychiatric illnesses remaining refractory to 'standard' therapies, neurosurgical procedures may be considered. Guidelines for safe and ethical conduct of such procedures have previously and independently been proposed by various local and regional expert groups. Methods: To expand on these earlier documents, representative members of continental and international psychiatric and neurosurgical societies, joined efforts to further elaborate and adopt a pragmatic worldwide set of guidelines. These are intended to address a broad range of neuropsychiatric disorders, brain targets and neurosurgical techniques, taking into account cultural and social heterogeneities of healthcare environmentsFindings: The proposed consensus document highlights that, while stereotactic ablative procedures such as cingulotomy and capsulotomy for depression and obsessive-compulsive disorder are considered 'established' in some countries, they still lack level I evidence. Further, it is noted that deep brain stimulation in any brain target hitherto tried, and for any psychiatric or behavioural disorder, still remains at an investigational stage. Researchers are encouraged to design randomised controlled trials, based on scientific and data-driven rationales for disease and brain target selection. Experienced multidisciplinary teams are a mandatory requirement for the safe and ethical conduct of any psychiatric neurosurgery, ensuring documented refractoriness of patients, proper consent procedures that respect patient's capacity and autonomy, multifaceted preoperative as well as postoperative long-term follow-up evaluation, and reporting of effects and side effects for all patients.Interpretation: This consensus document on ethical and scientific conduct of psychiatric surgery worldwide is designed to enhance patient safety. © 2014 by the BMJ Publishing Group Ltd.
    Original languageEnglish
    Pages (from-to)1003-1008
    Number of pages6
    JournalJournal of Neurology, Neurosurgery and Psychiatry
    Volume85
    Issue number9
    Early online date20 Jan 2014
    DOIs
    Publication statusPublished - 2014

    Fingerprint

    Neurosurgery
    Psychiatry
    Consensus
    Guidelines
    Brain Diseases
    Neurosurgical Procedures
    Deep Brain Stimulation
    Obsessive-Compulsive Disorder
    Patient Safety
    Randomized Controlled Trials
    Research Personnel
    Depression
    Delivery of Health Care
    Brain

    Cite this

    Nuttin, B., Wu, H., Mayberg, H., Hariz, M., Gabriëls, L., Galert, T., ... Schlaepfer, T. (2014). Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders. Journal of Neurology, Neurosurgery and Psychiatry, 85(9), 1003-1008. https://doi.org/10.1136/jnnp-2013-306580
    Nuttin, Bart ; Wu, Hemmings ; Mayberg, Helen ; Hariz, Marwan ; Gabriëls, Loes ; Galert, Thorsten ; Merkel, Reinhard ; Kubu, Cynthia ; Vilela-Filho, Osvaldo ; Matthews, Keith ; Taira, Takaomi ; Lozano, Andres M. ; Schechtmann, Gastón ; Doshi, Paresh ; Broggi, Giovanni ; Régis, Jean ; Alkhani, Ahmed ; Sun, Bomin ; Eljamel, Sam ; Schulder, Michael ; Kaplitt, Michael ; Eskandar, Emad ; Rezai, Ali ; Krauss, Joachim K. ; Hilven, Paulien ; Schuurman, Rick ; Ruiz, Pedro ; Chang, Jin Woo ; Cosyns, Paul ; Lipsman, Nir ; Voges, Juergen ; Cosgrove, Rees ; Li, Yongjie ; Schlaepfer, Thomas. / Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders. In: Journal of Neurology, Neurosurgery and Psychiatry. 2014 ; Vol. 85, No. 9. pp. 1003-1008.
    @article{2534482181774ab9b5c7b4b071838528,
    title = "Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders",
    abstract = "Background: For patients with psychiatric illnesses remaining refractory to 'standard' therapies, neurosurgical procedures may be considered. Guidelines for safe and ethical conduct of such procedures have previously and independently been proposed by various local and regional expert groups. Methods: To expand on these earlier documents, representative members of continental and international psychiatric and neurosurgical societies, joined efforts to further elaborate and adopt a pragmatic worldwide set of guidelines. These are intended to address a broad range of neuropsychiatric disorders, brain targets and neurosurgical techniques, taking into account cultural and social heterogeneities of healthcare environments. Findings: The proposed consensus document highlights that, while stereotactic ablative procedures such as cingulotomy and capsulotomy for depression and obsessive-compulsive disorder are considered 'established' in some countries, they still lack level I evidence. Further, it is noted that deep brain stimulation in any brain target hitherto tried, and for any psychiatric or behavioural disorder, still remains at an investigational stage. Researchers are encouraged to design randomised controlled trials, based on scientific and data-driven rationales for disease and brain target selection. Experienced multidisciplinary teams are a mandatory requirement for the safe and ethical conduct of any psychiatric neurosurgery, ensuring documented refractoriness of patients, proper consent procedures that respect patient's capacity and autonomy, multifaceted preoperative as well as postoperative long-term follow-up evaluation, and reporting of effects and side effects for all patients.Interpretation: This consensus document on ethical and scientific conduct of psychiatric surgery worldwide is designed to enhance patient safety. {\circledC} 2014 by the BMJ Publishing Group Ltd.",
    author = "Bart Nuttin and Hemmings Wu and Helen Mayberg and Marwan Hariz and Loes Gabri{\"e}ls and Thorsten Galert and Reinhard Merkel and Cynthia Kubu and Osvaldo Vilela-Filho and Keith Matthews and Takaomi Taira and Lozano, {Andres M.} and Gast{\'o}n Schechtmann and Paresh Doshi and Giovanni Broggi and Jean R{\'e}gis and Ahmed Alkhani and Bomin Sun and Sam Eljamel and Michael Schulder and Michael Kaplitt and Emad Eskandar and Ali Rezai and Krauss, {Joachim K.} and Paulien Hilven and Rick Schuurman and Pedro Ruiz and Chang, {Jin Woo} and Paul Cosyns and Nir Lipsman and Juergen Voges and Rees Cosgrove and Yongjie Li and Thomas Schlaepfer",
    year = "2014",
    doi = "10.1136/jnnp-2013-306580",
    language = "English",
    volume = "85",
    pages = "1003--1008",
    journal = "Journal of Neurology, Neurosurgery and Psychiatry",
    issn = "0022-3050",
    publisher = "BMJ Publishing Group",
    number = "9",

    }

    Nuttin, B, Wu, H, Mayberg, H, Hariz, M, Gabriëls, L, Galert, T, Merkel, R, Kubu, C, Vilela-Filho, O, Matthews, K, Taira, T, Lozano, AM, Schechtmann, G, Doshi, P, Broggi, G, Régis, J, Alkhani, A, Sun, B, Eljamel, S, Schulder, M, Kaplitt, M, Eskandar, E, Rezai, A, Krauss, JK, Hilven, P, Schuurman, R, Ruiz, P, Chang, JW, Cosyns, P, Lipsman, N, Voges, J, Cosgrove, R, Li, Y & Schlaepfer, T 2014, 'Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders', Journal of Neurology, Neurosurgery and Psychiatry, vol. 85, no. 9, pp. 1003-1008. https://doi.org/10.1136/jnnp-2013-306580

    Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders. / Nuttin, Bart (Lead / Corresponding author); Wu, Hemmings; Mayberg, Helen; Hariz, Marwan; Gabriëls, Loes; Galert, Thorsten; Merkel, Reinhard; Kubu, Cynthia; Vilela-Filho, Osvaldo; Matthews, Keith; Taira, Takaomi; Lozano, Andres M.; Schechtmann, Gastón; Doshi, Paresh; Broggi, Giovanni; Régis, Jean; Alkhani, Ahmed; Sun, Bomin; Eljamel, Sam; Schulder, Michael; Kaplitt, Michael; Eskandar, Emad; Rezai, Ali; Krauss, Joachim K.; Hilven, Paulien; Schuurman, Rick; Ruiz, Pedro; Chang, Jin Woo; Cosyns, Paul; Lipsman, Nir; Voges, Juergen; Cosgrove, Rees; Li, Yongjie; Schlaepfer, Thomas.

    In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 85, No. 9, 2014, p. 1003-1008.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Consensus on guidelines for stereotactic neurosurgery for psychiatric disorders

    AU - Nuttin, Bart

    AU - Wu, Hemmings

    AU - Mayberg, Helen

    AU - Hariz, Marwan

    AU - Gabriëls, Loes

    AU - Galert, Thorsten

    AU - Merkel, Reinhard

    AU - Kubu, Cynthia

    AU - Vilela-Filho, Osvaldo

    AU - Matthews, Keith

    AU - Taira, Takaomi

    AU - Lozano, Andres M.

    AU - Schechtmann, Gastón

    AU - Doshi, Paresh

    AU - Broggi, Giovanni

    AU - Régis, Jean

    AU - Alkhani, Ahmed

    AU - Sun, Bomin

    AU - Eljamel, Sam

    AU - Schulder, Michael

    AU - Kaplitt, Michael

    AU - Eskandar, Emad

    AU - Rezai, Ali

    AU - Krauss, Joachim K.

    AU - Hilven, Paulien

    AU - Schuurman, Rick

    AU - Ruiz, Pedro

    AU - Chang, Jin Woo

    AU - Cosyns, Paul

    AU - Lipsman, Nir

    AU - Voges, Juergen

    AU - Cosgrove, Rees

    AU - Li, Yongjie

    AU - Schlaepfer, Thomas

    PY - 2014

    Y1 - 2014

    N2 - Background: For patients with psychiatric illnesses remaining refractory to 'standard' therapies, neurosurgical procedures may be considered. Guidelines for safe and ethical conduct of such procedures have previously and independently been proposed by various local and regional expert groups. Methods: To expand on these earlier documents, representative members of continental and international psychiatric and neurosurgical societies, joined efforts to further elaborate and adopt a pragmatic worldwide set of guidelines. These are intended to address a broad range of neuropsychiatric disorders, brain targets and neurosurgical techniques, taking into account cultural and social heterogeneities of healthcare environments. Findings: The proposed consensus document highlights that, while stereotactic ablative procedures such as cingulotomy and capsulotomy for depression and obsessive-compulsive disorder are considered 'established' in some countries, they still lack level I evidence. Further, it is noted that deep brain stimulation in any brain target hitherto tried, and for any psychiatric or behavioural disorder, still remains at an investigational stage. Researchers are encouraged to design randomised controlled trials, based on scientific and data-driven rationales for disease and brain target selection. Experienced multidisciplinary teams are a mandatory requirement for the safe and ethical conduct of any psychiatric neurosurgery, ensuring documented refractoriness of patients, proper consent procedures that respect patient's capacity and autonomy, multifaceted preoperative as well as postoperative long-term follow-up evaluation, and reporting of effects and side effects for all patients.Interpretation: This consensus document on ethical and scientific conduct of psychiatric surgery worldwide is designed to enhance patient safety. © 2014 by the BMJ Publishing Group Ltd.

    AB - Background: For patients with psychiatric illnesses remaining refractory to 'standard' therapies, neurosurgical procedures may be considered. Guidelines for safe and ethical conduct of such procedures have previously and independently been proposed by various local and regional expert groups. Methods: To expand on these earlier documents, representative members of continental and international psychiatric and neurosurgical societies, joined efforts to further elaborate and adopt a pragmatic worldwide set of guidelines. These are intended to address a broad range of neuropsychiatric disorders, brain targets and neurosurgical techniques, taking into account cultural and social heterogeneities of healthcare environments. Findings: The proposed consensus document highlights that, while stereotactic ablative procedures such as cingulotomy and capsulotomy for depression and obsessive-compulsive disorder are considered 'established' in some countries, they still lack level I evidence. Further, it is noted that deep brain stimulation in any brain target hitherto tried, and for any psychiatric or behavioural disorder, still remains at an investigational stage. Researchers are encouraged to design randomised controlled trials, based on scientific and data-driven rationales for disease and brain target selection. Experienced multidisciplinary teams are a mandatory requirement for the safe and ethical conduct of any psychiatric neurosurgery, ensuring documented refractoriness of patients, proper consent procedures that respect patient's capacity and autonomy, multifaceted preoperative as well as postoperative long-term follow-up evaluation, and reporting of effects and side effects for all patients.Interpretation: This consensus document on ethical and scientific conduct of psychiatric surgery worldwide is designed to enhance patient safety. © 2014 by the BMJ Publishing Group Ltd.

    U2 - 10.1136/jnnp-2013-306580

    DO - 10.1136/jnnp-2013-306580

    M3 - Article

    VL - 85

    SP - 1003

    EP - 1008

    JO - Journal of Neurology, Neurosurgery and Psychiatry

    JF - Journal of Neurology, Neurosurgery and Psychiatry

    SN - 0022-3050

    IS - 9

    ER -