[Surgical targets in Psychiatric disorders. From movement to emotions]. / Dianas quirúrgicas en el tratamiento de enfermedades psiquiátricas.Desde el movimiento a las emociones.

Deep brain stimulation (DBS) for psychiatric disorders refractory to conventional treatments are currently been performed based on the knowledge obtained in the motor disorder surgery and mainly in Parkinson's disease. Depression, obsessive-compulsive disorder (OCD) and Tourette syndrome, all of them are cortico-striato-thalamo-cortical pathological process involved in the limbic loop of the basal ganglia. This review describes the different targets in these pathological neuro-psychiatric disorders. For OCD there are currently two targets, ventral striatum (VS) Accumbens nucleus (Nacc) and the subthalamic nucleus (STN). In refractory depression the subgenual area (25 Brodmann area) and VS/Nacc. For Tourette syndrome the ventralis oralis internus and centromedianum/parafascicularis of the thalamus (Voi and CM/Pf) and the internal part of the globus pallidus (GPi). Currently there are no specific surgical target for each pathological disorder because clinical results reported are very similar after stimulation surgery. In other point, a selected surgical target also may improve different pathologies.

Dianas quirúrgicas en el tratamiento de enfermedades psiquiátricas. Desde elmovimiento a las emociones / Surgical targets in Psychiatric disorders. From movement to emotions

La estimulación cerebral profunda para las enfermedadespsiquiátricas que son refractarias a los distintostratamientos convencionales, se está realizandoactualmente debido en gran parte a los conocimientosadquiridos en la cirugía para los trastornos del movimiento,sobre todo la enfermedad de Parkinson (EP).La depresión, los trastornos obsesivo-compulsivos(TOC) y el síndrome de Gilles de la Tourette son problemascórtico-estriato-tálamo-corticales relacionados conlos circuitos límbicos de los ganglios basales.En esta revisión se analizan las distintas dianas quirúrgicaspara las diferentes patologías neuro-psiquiátricas.Para el TOC actualmente existen dos dianas,el complejo estriado ventral (VS)-núcleo accumbens(Nacc) y el núcleo subtalámico (NST). Para la depresiónrefractaria, el área subgenual (área 25 de Brodmann)y el VS/Nacc. Para el Tourette, el ventralis oralisinterno y centromediano parafascicularis (Voi, CM/Pf)del tálamo y el globo pálido interno (GPi). En la actualidadno existe una única diana específica en cualquierade las patologías, ya que los resultados clínicos tras laestimulación pueden considerarse similares. Por otrolado, una misma diana quirúrgica puede mejorar diferentespatologías (AU)

Deep brain stimulation (DBS) for psychiatricdisorders refractory to conventional treatments arecurrently been performed based in the knowledgmentobtained in the motor disorder surgery and mainly inParkinson´s disease. Depression, obsessive-compulsivedisorder (OCD) and Tourette syndrome, all of them arecortico-striato-thalamo-cortical pathological processinvolved in the limbic loop of the basal ganglia.This review describes the different targets in thesepathological neuro-psychiatric disorders. For OCDthere are currently two targets, ventral striatum (VS)Accumbens nucleus (Nacc) and the subthalamic nucleus(STN). In refractory depression the subgenual area (25Brodmann area) and VS/Nacc. For Tourette syndromethe ventralis oralis internus and centromedianum/parafascicularis of the thalamus (Voi and CM/Pf) andthe internal part of the globus pallidus (GPi). Currentlythere are no specific surgical target for each pathologicaldisorder because clinical results reported arevery similar after stimulation surgery. In other point,a selected surgical target also may improve differentpathologies (AU)