Article

Deep brain stimulation for anorexia nervosa

The Lancet (Impact Factor: 45.22). 07/2013; 382(9889):305-306. DOI: 10.1016/S0140-6736(13)61630-X
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    ABSTRACT: The applications of deep brain stimulation (DBS) are rapidly increasing and now include a large variety of neurological and psychiatric diseases, such as depression, obsessive compulsive disorders, addiction, Alzheimer's disease, anorexia nervosa and rare movement disorders. These new applications confer a huge therapeutic potential in diseases for which often no treatment exists or which are refractory to existing therapies. This spread of applications, however, implies ethical problems in several domains: clinical use, research and presentation in the media and public. Thus, a systematic ethical analysis is needed to inform and guide this process. In this article we identify ethical problems involved in research and clinical use of novel DBS applications, suggest criteria and distinctions for structuring the ethical analysis, and articulate ethical demands for DBS research of novel applications.
    Full-text · Article · Aug 2013 · Der Nervenarzt
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    ABSTRACT: The applications of deep brain stimulation (DBS) are rapidly increasing and now include a large variety of neurological and psychiatric diseases, such as addiction, Alzheimer’s disease, anorexia nervosa, and rare movement disorders. High-quality data about benefit and harm of DBS in these disorders remain rare as many findings rely on small cohorts or single cases, variable methodologies, and differing outcome measures. Collectively, these problems make the field prone to bias and selective reporting, evoke ethical concerns regarding possibly premature expansions to new conditions without appropriate justification and research, and indicate the possibility that media, the public, and institutional review boards might be easily misguided by some reports. Thus, these problems are primarily not of scientific or methodological nature, but of ethical nature. Here, three approaches are suggested on how these problems might be reduced: by an optimization of trial designs, the implementation of standards of reporting, and the creation of a DBS study register which includes in particular single-case studies or case series. Future work has to work out these proposals in more detail and study its effectiveness when implemented in practice.
    Full-text · Article · Jan 2015