Suicidality Associated With Deep Brain Stimulation in Extrapyramidal Diseases: A Critical Review and Hypotheses on Neuroanatomical and Neuroimmune Mechanisms.
Parkinson’s disease
deep brain stimulation
extrapyramidal diseases
neuroinflammation
suicidal behavior (SB)
suicidal ideation (SI)
suicide
suicide attempt (SA)
Journal
Frontiers in integrative neuroscience
ISSN: 1662-5145
Titre abrégé: Front Integr Neurosci
Pays: Switzerland
ID NLM: 101477950
Informations de publication
Date de publication:
2021
2021
Historique:
received:
22
11
2020
accepted:
15
03
2021
entrez:
26
4
2021
pubmed:
27
4
2021
medline:
27
4
2021
Statut:
epublish
Résumé
Deep brain stimulation (DBS) is a very well-established and effective treatment for patients with extrapyramidal diseases. Despite its generally favorable clinical efficacy, some undesirable outcomes associated with DBS have been reported. Among such complications are incidences of suicidal ideation (SI) and behavior (SB) in patients undergoing this neurosurgical procedure. However, causal associations between DBS and increased suicide risk are not demonstrated and they constitute a debated issue. In light of these observations, the main objective of this work is to provide a comprehensive and unbiased overview of the literature on suicide risk in patients who received subthalamic nucleus (STN) and internal part of globus pallidum (GPi) DBS treatment. Additionally, putative mechanisms that might be involved in the development of SI and SB in these patients as well as caveats associated with these hypotheses are introduced. Finally, we briefly propose some clinical implications, including therapeutic strategies addressing these potential disease mechanisms. While a mechanistic connection between DBS and suicidality remains a controversial topic that requires further investigation, it is of critical importance to consider suicide risk as an integral component of candidate selection and post-operative care in DBS.
Identifiants
pubmed: 33897384
doi: 10.3389/fnint.2021.632249
pmc: PMC8060445
doi:
Types de publication
Journal Article
Langues
eng
Pagination
632249Informations de copyright
Copyright © 2021 Costanza, Radomska, Bondolfi, Zenga, Amerio, Aguglia, Serafini, Amore, Berardelli, Pompili and Nguyen.
Déclaration de conflit d'intérêts
KN is the scientific founder of Tranquis Therapeutics, a neuroimmunology company that develops immunotherapies for neurological diseases. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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