Lateral habenula deep brain stimulation for personalized treatment of drug addiction

Abstract

This opinion discusses, the lateral habenula (LHb) as a prominent target site for deep brain stimulation (DBS) treatment of drug addiction. Drug addiction is a major brain disease, and a serious clinical and social problem. One of the prominent treatments approaches is DBS, in which implanted electrodes deliver electrical stimulation to stereotactically targeted brain regions. The authors postulate that better results may be obtained by targeting more remote limbic regions which regulate the mesolimbic dopaminergic system, such as the LHb. As in many other therapies, treatment of addiction also exhibits a wide variability in longitudinal efficacy. Therefore, early identification of factors which reduce treatment efficacy can assist in establishing inclusion and exclusion criteria, and facilitate optimal patient management. This supports the use of brain imaging for monitoring cocaine-induced alterations in brain anatomy and fiber connectivity, prior to DBS treatment. Specifically, diffusion tensor imaging (DTI) biomarkers for detection of cocaine-induced alterations in fasciculus retroflexus anatomy may be useful for identification and selection of potential responders to LHb DBS. Therefore, LHb electrical stimulation, with DTI as a noninvasive, pre-surgical diagnostic tool, may serve as an individualized treatment for drug addiction disorders, mainly for cases in which more conventional treatments such as psychotherapy and pharmacological treatments have failed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)