Neurosurgery in the Treatment of Alcohol Use Disorder: A Systematic Literature Review
Arq. bras. neurocir
;
41(1): 76-84, 07/03/2022.
Artigo
em Inglês
| LILACS
| ID: biblio-1362091
ABSTRACT
Alcohol abuse has impacts on public health worldwide. Conservative treatment to achieve abstinence consists of detoxification combined with psychotherapy and the use of drugs, but it is estimated that only half of the individuals achieve long-term abstinence with the available treatments. In this sense, neurosurgery appears as a therapeutic proposal. The present study aimed to gather information about the circuitry related to alcohol use disorder (AUD), to describe possible surgical targets, and to establish whether a surgical approach could be a safe and effective treatment option. A systematic review of the literature was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The 14 selected articles analyze ablative operations, deep brain stimulation (DBS), and a new procedure in which the patient is first submitted to repetitive transcranial magnetic stimulation to evaluate their response, and later an implant is surgically positioned on the evaluated target to obtain more lasting results. The most relevant outcomes were found when the anterior cingulate cortex (ACC) and the nucleus accumbens (NAcc) were used as targets, demonstrating a large reduction in alcohol intake and even its cessation. However, important side effects were observed, such as psychotic symptoms, right frontal venous infarction, seizures after implantation in the ACC and a hypomanic period after DBS in the NAcc, which could be reversed. Due to the lack of studies involving the surgical treatment of AUD, more clinical trials are needed to compare targets, to assess surgical techniques, and to estimate the safety of these techniques.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Estimulação Encefálica Profunda
/
Alcoolismo
/
Estimulação Magnética Transcraniana
/
Técnicas de Ablação
Tipo de estudo:
Revisões Sistemáticas Avaliadas
Idioma:
Inglês
Revista:
Arq. bras. neurocir
Assunto da revista:
Cirurgia
/
Neurocirurgia
Ano de publicação:
2022
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Pontifícia Universidade Católica de Goiás/BR
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