Abstract
Addiction is a major public-health crisis associated with significant disability and mortality. Although various pharmacological and behavioral treatments are currently available, the clinical efficacy of these treatments is limited. Given this situation, there is a growing interest in finding an effective neurosurgical treatment for addiction. First, we discuss the use of ablative surgery in treating addiction. We focus on the rise and fall of nucleus accumbens ablation for addiction in China. Subsequently, we review recent studies that have explored the efficacy and safety of deep-brain-stimulation treatment for addiction. We conclude that neurosurgical procedures, particularly deep-brain stimulation, have a potentially valuable role in the management of otherwise intractable addictive disorders. Larger well-controlled clinical trials, however, are needed to assess clinical efficacy and safety. We end by discussing several key issues involved in this clinical field and identifying some areas of progress.
Highlights
Addiction is characterized by intense and sometimes uncontrollable craving and compulsive addictivesubstance seeking, which persist despite severe and potentially fatal consequences [1]
We focus on the rise and fall of nucleus accumbens ablation for addiction in China
In 2015, a global survey showed that tobacco smoking, alcohol and drug use were associated with 16.2% of the total disease burden in men [6]
Summary
Addiction is characterized by intense and sometimes uncontrollable craving and compulsive addictivesubstance seeking, which persist despite severe and potentially fatal consequences [1]. At the final follow-up, the patient was drug-free for more than 6 months, except for a 14-day relapse [52] In line with these case reports, Kuhn et al reported that NAc DBS was effective in treating two patients who were chronic users of heroin as well as of other addictive drugs. After treatment, both patients showed reduced levels of anxiety and depression [53]. Two years after DBS, the clinical benefits were still evident, yet they were smaller than
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