{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T10:59:23Z","timestamp":1791543563419,"version":"4.3.4"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>There were more than 107,000 drug overdose deaths in the US in 2021, the most ever recorded. Despite advances in behavioral and pharmacological treatments, over 50% of those receiving treatment for opioid use disorder (OUD) experience drug use recurrence (relapse). Given the prevalence of OUD and other substance use disorders (SUDs), the high rate of drug use recurrence, and the number of drug overdose deaths, novel treatment strategies are desperately needed. The objective of this study was to evaluate the safety and feasibility of deep brain stimulation (DBS) targeting the nucleus accumbens (NAc)\/ventral capsule (VC) and potential impact on outcomes in individuals with treatment-refractory OUD.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A prospective, open-label, single-arm study was conducted among participants with longstanding treatment-refractory OUD (along with other co-occurring SUDs) who underwent DBS in the NAc\/VC. The primary study endpoint was safety; secondary\/exploratory outcomes included opioid and other substance use, substance craving, and emotional symptoms throughout follow-up and <jats:sup>18<\/jats:sup>FDG-PET neuroimaging.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Four male participants were enrolled and all tolerated DBS surgery well with no serious adverse events (AEs) and no device- or stimulation-related AEs. Two participants sustained complete substance abstinence for &gt; 1150 and &gt; 520 days, respectively, with significant post-DBS reductions in substance craving, anxiety, and depression. One participant experienced post-DBS drug use recurrences with reduced frequency and severity. The DBS system was explanted in one participant due to noncompliance with treatment requirements and the study protocol. <jats:sup>18<\/jats:sup>FDG-PET neuroimaging revealed increased glucose metabolism in the frontal regions for the participants with sustained abstinence only.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>DBS of the NAc\/VC was safe, feasible, and can potentially reduce substance use, craving, and emotional symptoms in those with treatment-refractory OUD. A randomized, sham-controlled trial in a larger cohort of patients is being initiated.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.4.jns23114","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T16:18:28Z","timestamp":1686413908000},"page":"231-239","source":"Crossref","is-referenced-by-count":40,"title":["Safety and feasibility clinical trial of nucleus accumbens deep brain stimulation for treatment-refractory opioid use disorder"],"prefix":"10.3171","volume":"140","author":[{"given":"Ali R.","family":"Rezai","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Neuroscience,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Neuroscience,"},{"name":"Behavioral Medicine and Psychiatry,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc W.","family":"Haut","sequence":"additional","affiliation":[{"name":"Neuroscience,"},{"name":"Behavioral Medicine and Psychiatry,"},{"name":"Neurology,"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanhong","family":"Zheng","sequence":"additional","affiliation":[{"name":"Neuroscience,"},{"name":"Behavioral Medicine and Psychiatry,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura R.","family":"Lander","sequence":"additional","affiliation":[{"name":"Neuroscience,"},{"name":"Behavioral Medicine and Psychiatry,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"Berry","sequence":"additional","affiliation":[{"name":"Neuroscience,"},{"name":"Behavioral Medicine and Psychiatry,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L.","family":"Farmer","sequence":"additional","affiliation":[{"name":"Neuroscience,"},{"name":"Behavioral Medicine and Psychiatry,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Marton","sequence":"additional","affiliation":[{"name":"Neuroscience,"},{"name":"Behavioral Medicine and Psychiatry,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padma","family":"Tirumalai","sequence":"additional","affiliation":[{"name":"Neuroscience,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Mears","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisy G. Y.","family":"Thompson-Lake","sequence":"additional","affiliation":[{"name":"Neuroscience,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor S.","family":"Finomore","sequence":"additional","affiliation":[{"name":"Neuroscience,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Fran\u00e7ois","family":"D\u2019Haese","sequence":"additional","affiliation":[{"name":"Neuroradiology, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, West Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will M.","family":"Aklin","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"George","sequence":"additional","affiliation":[{"name":"National Institute on Alcohol Abuse and Addiction, NIH, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Corrigan","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally L.","family":"Hodder","sequence":"additional","affiliation":[{"name":"West Virginia Clinical & Translational Science Institute, West Virginia University, Morgantown, West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","article-title":"Substance Abuse and Mental Health Services Administration","unstructured":"2020NSDUH detailed tables. 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Accessed May 3, 2023.https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm"},{"issue":"5","key":"b4","series-title":"Addiction","first-page":"1187","article-title":"Responding to 100 000 annual drug overdose deaths in the United States: a special section of commentaries","volume":"117","author":"Humphreys K","year":"2022","unstructured":"Humphreys K, Marsden J. Responding to 100 000 annual drug overdose deaths in the United States: a special section of commentaries. Addiction. 2022;117(5):1187."},{"issue":"12","key":"b5","series-title":"Arch Gen Psychiatry","first-page":"1238","article-title":"Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence: a 2-phase randomized controlled trial","volume":"68","author":"Weiss RD","year":"2011","unstructured":"Weiss RD, Potter JS, Fiellin DA,  Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence: a 2-phase randomized controlled trial. 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