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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2020; 39(02): 116-124
DOI: 10.1055/s-0040-1702976
Review Article | Artigo de Revisão
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Neurosurgical Treatment for Drug Addiction: Systematic Review

Tratamento neurocirúrgico para drogadição: Revisão sistemática
Patrícia Leonardo Magalhães dos Santos 
1   Departament of Medicine, Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Pontifícia Universidade Católica de Goiás (PUC-Goiás), Goiânia, GO, Brazil
,
Rafaella Oliveira Curti 
1   Departament of Medicine, Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Pontifícia Universidade Católica de Goiás (PUC-Goiás), Goiânia, GO, Brazil
,
Ledismar José da Silva 
1   Departament of Medicine, Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Pontifícia Universidade Católica de Goiás (PUC-Goiás), Goiânia, GO, Brazil
› Author Affiliations
Further Information

Publication History

08 October 2019

11 December 2019

Publication Date:
06 April 2020 (online)

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Abstract

Substance-related disorders are psychiatric conditions that have a worldwide impact. Their multifactorial cycle has been treated pharmacologically and with therapeutic support. However, high refractoriness rates and difficulty to control relapses are among the pitfalls associated with these disorders. Thus, recent studies have shown that deep brain stimulation (DBS) is a promising treatment, with a direct intervention in the neurocircuitry of addiction. The results of the present systematic review of the use of DBS for the treatment of drug addiction show that this surgical procedure can reduce the desire for the drug, and, in some cases, establish abstinence, improve psychiatric symptoms related to mood and quality of life, and reintroduce the patient into the social and family environments. Nevertheless, this approach is still limited to the academic realm, based mainly on case reports, with ethics and therapeutic protocols still to be defined. Further in-depth scientific investigations are required to recommend its clinical application.

Resumo

Os transtornos relacionados ao uso de substâncias são desordens psiquiátricas com impacto mundial. Seu ciclo multifatorial tem sido tratado farmacologicamente e com apoio terapêutico. Entretanto, as altas taxas de refratariedade e a dificuldade no controle das recaídas estão entre os perigos associados com essas desordens. Dessa forma, estudos recentes mostraram que a estimulação cerebral profunda (ECP) é um tratamento promissor, em que é feita uma intervenção direta na neurocircuitaria do vício. Os resultados desta revisão sistemática da literatura sobre a aplicação de ECP no tratamento de dependência química demonstram que este é um procedimento cirúrgico capaz de reduzir o desejo pela droga, e, em alguns casos, estabelecer a abstinência, melhorar os sintomas psiquiátricos relacionados ao humor e à qualidade de vida, e reintroduzir o paciente no ambiente social e familiar. No entanto, esta ainda é uma abordagem limitada ao âmbito acadêmico, baseada principalmente em relatos de casos, com questões éticas e protocolos terapêuticos a serem definidos. É necessário maior aprofundamento científico para que sua aplicação clínica seja recomendada.

Keywords

substance-related disorders - deep brain stimulation - systematic review

Palavras-chave

transtornos relacionados ao uso de substâncias - estimulação cerebral profunda - revisão sistemática
 

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