{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T15:59:39Z","timestamp":1776959979019,"version":"3.51.4"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T00:00:00Z","timestamp":1633910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Self-destructive and aggressive behaviors can have a significant impact on the quality of life of affected individuals and their carrers. While deep brain stimulation (DBS) has been applied to the treatment of self-destructive and aggressive behaviors in isolated cases, clinical data on this treatment modality are still lacking. We therefore assessed responses to treatment with bilateral DBS of the nucleus accumbens in six patients with severe self-destructive and aggressive behaviors. Three patients had Tourette syndrome and three had other underlying predispositions including obsessive compulsive disorder, cerebral palsy, encephalitis, and epilepsy. Patients were followed up for between 2 and 7 years, and patients were assessed using the Modified Overt Aggression Scale (six patients) and the Buss-Perry Aggression Questionnaire (three patients able to complete the questionnaire on their own). DBS reduced self-destructive and aggressive behaviors by 30\u2013100% and by an average of 74.5%. Patients with Tourette syndrome responded better to DBS and improved by 27.3% according to the Buss-Perry Aggression Questionnaire. These results suggest that nuclei accumbens stimulation may be an effective treatment for aggressive and self-destructive behaviors regardless of etiology.<\/jats:p>","DOI":"10.3389\/fneur.2021.706166","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T11:37:42Z","timestamp":1633952262000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Treating Aggression and Self-destructive Behaviors by Stimulating the Nucleus Accumbens: A Case Series"],"prefix":"10.3389","volume":"12","author":[{"given":"Marek","family":"Harat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Kiec","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Ruda\u015b","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Birski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Furtak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1176\/appi.ajp.2008.07111774","article-title":"Neurobiology of aggression and violence","volume":"165","author":"Siever","year":"2008","journal-title":"Am J Psychiatr."},{"key":"B2","first-page":"968","article-title":"The effect of partial amygdalectomy on emotional disturbances and epileptic seizures","volume":"10","author":"Mempel","year":"1971","journal-title":"Pol Med J."},{"key":"B3","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1007\/978-3-7091-8592-6_20","article-title":"The effect of medial amygdalotomy and anterior hippocampotomy on behavior and seizures in epileptic patients","volume":"30","author":"Mempel","year":"1980","journal-title":"Acta Neurochir Suppl"},{"key":"B4","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1159\/000103429","article-title":"Epileptic seizures and the stereotaxic amygdalotomy","volume":"32","author":"Narabayashi","year":"1970","journal-title":"Confin Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1001\/archneur.1963.00460070011001","article-title":"Stereotaxic amygdalotomy for behavior disorders","volume":"9","author":"Narabayashi","year":"1963","journal-title":"Arch Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1159\/000103950","article-title":"Long range results of stereotaxic amygdalotomy for behavior disorders","volume":"27","author":"Narabayashi","year":"1966","journal-title":"Confin Neurol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1001\/jama.1966.03110200097026","article-title":"Stereotaxic amygdalotomy for epilepsy with aggressive behavior","volume":"198","author":"Heimburger","year":"1966","journal-title":"JAMA"},{"key":"B8","doi-asserted-by":"publisher","first-page":"S40","DOI":"10.4103\/2152-7806.91609","article-title":"The amygdala as a target for behavior surgery","volume":"3","author":"Langevin","year":"2012","journal-title":"Surg Neurol Int."},{"key":"B9","doi-asserted-by":"publisher","first-page":"689","DOI":"10.3171\/jns.1970.33.6.0689","article-title":"Results of stimulation and destruction of the posterior hypothalamus in man","volume":"33","author":"Sano","year":"1970","journal-title":"J Neurosurg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1159\/000086675","article-title":"Stimulation of the posterior hypothalamus for medically intractable impulsive and violent behavior","volume":"83","author":"Franzini","year":"2005","journal-title":"Stereotact Funct Neurosurg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1159\/000431373","article-title":"Deep brain stimulation in pathological aggression","volume":"93","author":"Harat","year":"2015","journal-title":"Stereotact Funct Neurosurg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"341","DOI":"10.3389\/fnhum.2012.00341","article-title":"DBS in the basolateral amygdala improves symptoms of autism and related self-injurious behavior: a case report and hypothesis on the pathogenesis of the disorder","volume":"6","author":"Sturm","year":"2012","journal-title":"Front Hum Neurosci."},{"key":"B13","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00701-016-3002-2","article-title":"Nucleus accumbens deep brain stimulation for a patient with self-injurious behavior and autism spectrum disorder: functional and structural changes of the brain: report of a case and review of literature","volume":"159","author":"Park","year":"2017","journal-title":"Acta Neurochir."},{"key":"B14","first-page":"3","volume-title":"Anatomy of Neuropsychiatry: The New Anatomy of the Basal Forebrain and its Implications for Neuropsychiatric Illness","author":"Heimer","year":"2007"},{"key":"B15","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/0301-0082(80)90018-0","article-title":"From motivation to action: functional interface between the limbic system and the motor system","volume":"14","author":"Mogenson","year":"1980","journal-title":"Prog Neurobiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1001\/archpsyc.1997.01830150047009","article-title":"Mesolimbic dopamine D3 receptors and use of antipsychotics in patients with schizophrenia. a postmortem study","volume":"54","author":"Gurevich","year":"1997","journal-title":"Arch Gen Psychiatr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2308","DOI":"10.1212\/WNL.44.12.2308","article-title":"The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia","volume":"44","author":"Cummings","year":"1994","journal-title":"Neurology"},{"key":"B18","first-page":"151","volume-title":"Frontal-Subcortical Circuits in Psychiatric and Neurological Disorders","author":"Lichter","year":"2001"},{"key":"B19","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1111\/j.1468-3148.2006.00346.x","article-title":"Modified Overt Aggression Scale (MOAS) for people with intellectual disability and aggressive challenging behavior: a reliability study","volume":"20","author":"Oliver","year":"2007","journal-title":"J Appl Res Intellect Disabil."},{"key":"B20","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1002\/ab.20146","article-title":"The relation between scores on the Buss\u2013Perry Aggression Questionnaire and aggressive acts, impulsiveness, competitiveness, dominance, and sexual jealousy","volume":"32","author":"Archer","year":"2006","journal-title":"Aggress Behav Off J Int Soc Res Aggress."},{"key":"B21","doi-asserted-by":"publisher","first-page":"xv","DOI":"10.1016\/S1042-3680(03)00007-X","article-title":"Deep brain stimulation for psychiatric disorders","volume":"14","author":"Nuttin","year":"2003","journal-title":"Neurosurg Clin N Am."},{"key":"B22","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.wneu.2019.02.021","article-title":"Nucleus accumbens deep brain stimulation for obsessive-compulsive disorder and aggression in an autistic patient: a case report and hypothesis of the role of nucleus accumbens in autism and comorbid symptoms","volume":"125","author":"Doshi","year":"2019","journal-title":"World Neurosurg."},{"key":"B23","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s10143-011-0359-9","article-title":"Deep brain stimulation for obesity\u2013from theoretical foundations to designing the first human pilot study","volume":"35","author":"Tomycz","year":"2012","journal-title":"Neurosurg Rev."},{"key":"B24","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1007\/s00415-006-0404-8","article-title":"Deep brain stimulation of the nucleus accumbens and the internal capsule in therapeutically refractory Tourette-syndrome","volume":"254","author":"Kuhn","year":"2007","journal-title":"J Neurol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/978-3-7091-1482-7_9","article-title":"Active stimulation site of nucleus accumbens deep brain stimulation in obsessive-compulsive disorder is localized in the ventral internal capsule","volume":"117","author":"van den Munckhof","year":"2013","journal-title":"Acta Neurochir Suppl."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2019.11.JNS192608","article-title":"Deep brain stimulation for aggressiveness: long-term follow-up and tractography study of the stimulated brain areas","volume":"7","author":"Torres","year":"2020","journal-title":"J Neurosurg"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.706166\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T11:37:46Z","timestamp":1633952266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.706166\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,11]]},"references-count":26,"alternative-id":["10.3389\/fneur.2021.706166"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.706166","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,11]]},"article-number":"706166"}}