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Nucleus Accumbens Surgery for Addiction.
MedLine Citation:
PMID:  23046915     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Opiate addiction remains intractable in a large percentage of patients, and relapse is biggest hurdles to recovery because of the psychological dependence. Multiple studies identify a central role of the nucleus accumbens (NAc) in addiction; several studies note decreased addictive behavior after interventions in this area. Based on animal experiment, our institute started the clinical trial for the treatment of drug addicts' psychological dependence by making lesions in the bilateral NAc with stereotactic surgery from July 2000.The short-term outcomes were encourage and triggered rapid application of this treatment in China from 2003 to 2004. However, lack of long-term outcomes and controversy eventually lead to halting the surgery for addiction by Ministry of Health of China in November 2004 and a nationwide survey about it later. Our institute had performed this surgery in 272 patients with severe heroin addiction. The follow up study showed the 5 years non-relapse rate was 58% and the quality of life was significantly improved. The patients had several kinds of side effects, but the incidence rate is relatively low. The patients gradually recovered in more than 5 years after the surgery. The side effects would not severely influence individual life and work. Nationwide surgery showed the non-relapse rate was 50% in the sample of 150 cases,from 1167 patients in all who underwent stereotactic surgery in China. Although sometimes accompanied by neuropsychological adverse events, stereotactic ablation of NAc may effectively treat opiate addiction. Lesion location has significantly impacts on treatment efficacy and need further studies. Since ablation is irreversible, the NAc Surgery for addiction should be performed with cautiousness and the deep brain stimulation(DBS)is ideal alternative.
Authors:
Nan Li; Jing Wang; Xue-Lien Wang; Chong-Wang Chang; Shun-Nan Ge; Li Gao; He-Ming Wu; Hai-Kang Zhao; Ning Geng; Guo-Dong Gao
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-6
Journal Detail:
Title:  World neurosurgery     Volume:  -     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
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