Die entwicklung der tiefen hirnstimulation bei der behandlung therapieresistenter psychiatrischer erkrankungen

Since approximately 10 years investigations have been carried out on the impact of deep brain stimulation (DBS) of treatment-resistant obsessive-compulsive disorders and depression. New fields of application are for Tourette's syndrome, substance abuse, dementia and anxiety. New functional, structural and molecular data have led to a new conceptualization of these disorders as dysfunctions of networks which process motivational and affective stimuli. DBS permits the selective and basically reversible modulation of such networks. So far adverse effects have been graded as marginal. In the field of treatment-resistant obsessive-compulsive disorders and depressive disorders uncontrolled studies have been published with initial satisfactory and concordant indications of the therapeutic effect of DBS in a variety of target areas of the brain. It is most important to provide a consistent interdisciplinary and durable development of concepts for a responsible use of DBS in patients with psychiatric disorders. Only in this way can the potentially most interesting therapeutic development of clinical psychiatry of the last 20 years be continued uninterrupted.