{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:54:39Z","timestamp":1789577679188,"version":"build-2803163510"},"reference-count":85,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Neurology International"],"abstract":"<jats:p>Deep brain stimulation (DBS) is an evolving neurosurgical treatment, originally developed for movement disorders such as Parkinson\u2019s disease, essential tremor, and dystonia. In recent years, it has been increasingly applied to psychiatric and cognitive disorders. This review aimed to summarize the psychological and neuroethical dimensions of DBS, with particular attention to cognitive, emotional, and personality-related outcomes. While DBS can significantly enhance quality of life, it may also lead to subtle or overt changes in cognition, affect, and self-perception, especially in patients with neuropsychiatric comorbidities. Comprehensive psychological evaluation, both pre- and post-operatively, is essential. Findings from recent trials highlight a balance of potential risks and benefits that must be communicated transparently to patients. From a neuroethical perspective, DBS raises important questions regarding personal identity and autonomy, concerns that will become increasingly relevant as the technology advances. This paper underscores the need for more systematic research and the development of personalized care protocols that address not only motor outcomes but also psychosocial well-being.<\/jats:p>","DOI":"10.3390\/neurolint17100158","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:07:48Z","timestamp":1759417668000},"page":"158","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Deep Brain Stimulation: Psychological and Neuroethical Perspectives"],"prefix":"10.3390","volume":"17","author":[{"given":"Stella","family":"Sremic","sequence":"first","affiliation":[{"name":"Department of Clinical, Health and Organizational Psychology, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antea","family":"Krsek","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2837-4157","authenticated-orcid":false,"given":"Lara","family":"Baticic","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.14802\/jmd.20052","article-title":"Update on current technologies for deep brain stimulation in Parkinson\u2019s disease","volume":"13","author":"Paff","year":"2020","journal-title":"J. Mov. Disord."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e00313","DOI":"10.1016\/j.neurot.2023.e00313","article-title":"The role of the motor thalamus in deep brain stimulation for essential tremor","volume":"21","author":"Neudorfer","year":"2024","journal-title":"Neurotherapeutics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"108750","DOI":"10.1016\/j.jneumeth.2020.108750","article-title":"Deep brain stimulation in dystonia: State of art and future directions","volume":"340","author":"Macerollo","year":"2020","journal-title":"J. Neurosci. Methods"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"162","DOI":"10.2741\/4586","article-title":"Deep brain stimulation: Foundations and future trends","volume":"23","author":"Aum","year":"2018","journal-title":"Front. Biosci. (Landmark Ed.)"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1038\/s41582-018-0128-2","article-title":"Deep brain stimulation: Current challenges and future directions","volume":"15","author":"Lozano","year":"2019","journal-title":"Nat. Rev. Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1038\/nrneurol.2017.105","article-title":"Insights into the mechanisms of deep brain stimulation","volume":"13","author":"Ashkan","year":"2017","journal-title":"Nat. Rev. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1038\/s41587-019-0244-6","article-title":"Emerging technologies for improved deep brain stimulation","volume":"37","author":"Cagnan","year":"2019","journal-title":"Nat. Biotechnol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1038\/s41582-020-00426-z","article-title":"Technology of deep brain stimulation: Current status and future directions","volume":"17","author":"Krauss","year":"2021","journal-title":"Nat. Rev. Neurol."},{"key":"ref_9","first-page":"393","article-title":"Age limits for deep brain stimulation of subthalamic nuclei in Parkinson\u2019s disease","volume":"6","author":"Bouwyn","year":"2016","journal-title":"J. Park. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1177\/1073858415581986","article-title":"Mechanism of deep brain stimulation: Inhibition, excitation, or disruption?","volume":"22","author":"Chiken","year":"2016","journal-title":"Neuroscientist"},{"key":"ref_11","first-page":"2239","article-title":"Deep brain stimulation and the thalamus: Anatomy and implications for surgical targeting","volume":"225","author":"Florence","year":"2020","journal-title":"Brain Struct. Funct."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.nbd.2009.09.022","article-title":"Network perspectives on the mechanisms of deep brain stimulation","volume":"38","author":"McIntyre","year":"2010","journal-title":"Neurobiol. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1152\/jn.00989.2003","article-title":"Cellular effects of deep brain stimulation: Model-based analysis of activation and inhibition","volume":"91","author":"McIntyre","year":"2004","journal-title":"J. Neurophysiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2111","DOI":"10.1002\/mds.22120","article-title":"Latest view on the mechanism of action of deep brain stimulation","volume":"23","author":"Hammond","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_15","first-page":"776","article-title":"Network activation during DBS of the subthalamic nucleus and its clinical relevance for speech","volume":"15","author":"Anderson","year":"2022","journal-title":"Brain Stimul."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1146\/annurev-neuro-061010-113638","article-title":"Deep brain stimulation for psychiatric disorders","volume":"34","author":"Holtzheimer","year":"2011","journal-title":"Annu. Rev. Neurosci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1001\/jamapsychiatry.2016.0152","article-title":"Deep brain stimulation of the ventral anterior limb of the internal capsule for treatment-resistant depression: A randomized clinical trial","volume":"73","author":"Bergfeld","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.neuron.2005.02.014","article-title":"Deep brain stimulation for treatment-resistant depression","volume":"45","author":"Mayberg","year":"2005","journal-title":"Neuron"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S192","DOI":"10.1016\/S1353-8020(13)70045-2","article-title":"Deep brain stimulation: New techniques","volume":"20","author":"Hariz","year":"2014","journal-title":"Park. Relat. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.nurt.2007.10.065","article-title":"Deep brain stimulation for epilepsy","volume":"5","author":"Halpern","year":"2008","journal-title":"Neurotherapeutics"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"315","DOI":"10.3171\/2011.10.JNS102122","article-title":"A multicenter pilot study of subcallosal cingulate area deep brain stimulation for treatment-resistant depression","volume":"116","author":"Lozano","year":"2012","journal-title":"J. Neurosurg."},{"key":"ref_22","first-page":"e35","article-title":"Deep brain stimulation for depression: Where are we targeting?","volume":"69","author":"Fenoy","year":"2011","journal-title":"Biol. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1016\/j.neubiorev.2010.12.009","article-title":"Cross-species affective functions of the medial forebrain bundle\u2014Implications for the treatment of affective pain and depression in humans","volume":"35","author":"Coenen","year":"2011","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.biopsych.2014.03.029","article-title":"Defining critical white matter pathways mediating successful subcallosal cingulate deep brain stimulation for treatment-resistant depression","volume":"76","author":"Choi","year":"2014","journal-title":"Biol. Psychiatry"},{"key":"ref_25","first-page":"E9","article-title":"Deep brain stimulation in the treatment of anorexia nervosa and obesity: A review of past experience","volume":"49","author":"McLaughlin","year":"2020","journal-title":"Neurosurg. Focus"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1152\/jn.00281.2015","article-title":"Mechanisms of deep brain stimulation","volume":"115","author":"Herrington","year":"2016","journal-title":"J. Neurophysiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/WCO.0000000000000226","article-title":"Deep brain stimulation for movement disorders: 2015 and beyond","volume":"28","author":"Fasano","year":"2015","journal-title":"Curr. Opin. Neurol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1038\/nrn2196","article-title":"Translational principles of deep brain stimulation","volume":"8","author":"Kringelbach","year":"2007","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_29","first-page":"195","article-title":"Cognitive effects of subthalamic nucleus stimulation in Parkinson\u2019s disease: From clinical observations to animal models","volume":"11","author":"Temel","year":"2005","journal-title":"Park. Relat. Disord."},{"key":"ref_30","first-page":"345","article-title":"Deep brain stimulation for Parkinson\u2019s disease","volume":"26","author":"Zhang","year":"2010","journal-title":"Neurosci. Bull."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1159\/000064611","article-title":"Stimulation of the central medial thalamic nucleus for epilepsy","volume":"77","author":"Velasco","year":"2001","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"ref_32","first-page":"1207","article-title":"Deep brain stimulation for refractory epilepsy: A meta-analysis of randomized controlled trials","volume":"43","author":"Wang","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Sakas, D.E., Panourias, I.G., and Simpson, B.A. (2007). An introduction to operative neuromodulation. Operative Neuromodulation, Vol. 1: Functional Neuroprosthetic Surgery, Springer.","DOI":"10.1007\/978-3-211-33079-1"},{"key":"ref_34","unstructured":"Hariz, M.I., Blomstedt, P., and Zrinzo, L. (2015). Deep brain stimulation: New techniques. Neuromodulation in Psychiatry, Springer."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Rossi, P.J., Gunduz, A., Judy, J.W., Denison, T., Grill, W.M., Kirsch, R.F., Kumar, R., McIntyre, C.C., Nassi, J.J., and Otto, K.J. (2016). Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A review of emerging issues and technologies. Front. Integr. Neurosci., 10.","DOI":"10.3389\/fnint.2016.00038"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.biopsych.2009.11.028","article-title":"Deep brain stimulation for intractable obsessive compulsive disorder: Pilot study using a blinded, staggered-onset design","volume":"67","author":"Goodman","year":"2010","journal-title":"Biol. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1056\/NEJMoa0708514","article-title":"Subthalamic nucleus stimulation in severe obsessive\u2013compulsive disorder","volume":"359","author":"Mallet","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_38","first-page":"516","article-title":"Deep brain stimulation for obsessive\u2013compulsive disorder: A double-blind crossover trial","volume":"78","author":"Kuhn","year":"2015","journal-title":"Biol. Psychiatry"},{"key":"ref_39","first-page":"283","article-title":"Treatment of patients with intractable obsessive\u2013compulsive disorder with anterior capsular stimulation","volume":"60","author":"Anderson","year":"2003","journal-title":"Case Rep. Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1038\/mp.2015.124","article-title":"Electrical stimulation in the bed nucleus of the stria terminalis alleviates severe obsessive\u2013compulsive disorder","volume":"21","author":"Luyten","year":"2016","journal-title":"Mol. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"7122","DOI":"10.1523\/JNEUROSCI.3237-12.2013","article-title":"Amelioration of binge eating by nucleus accumbens shell deep brain stimulation in mice involves D2 receptor modulation","volume":"33","author":"Halpern","year":"2013","journal-title":"J. Neurosci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1002\/acn3.682","article-title":"Deep brain stimulation: Potential for neuroprotection","volume":"6","author":"McKinnon","year":"2018","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1093\/brain\/awx010","article-title":"The modulatory effect of adaptive deep brain stimulation on beta bursts in Parkinson\u2019s disease","volume":"140","author":"Tinkhauser","year":"2017","journal-title":"Brain"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/S0140-6736(12)62188-6","article-title":"Subcallosal cingulate deep brain stimulation for treatment-refractory anorexia nervosa: A phase 1 pilot trial","volume":"381","author":"Lipsman","year":"2013","journal-title":"Lancet"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1002\/mds.26241","article-title":"Adaptive deep brain stimulation in a freely moving Parkinsonian patient","volume":"30","author":"Rosa","year":"2015","journal-title":"Mov. Disord."},{"key":"ref_46","first-page":"1","article-title":"Deep brain stimulation for epilepsy: Challenges and opportunities","volume":"20","author":"Nair","year":"2020","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.seizure.2013.08.005","article-title":"Seizure outcome after hippocampal deep brain stimulation in patients with refractory temporal lobe epilepsy","volume":"23","author":"Cukiert","year":"2014","journal-title":"Seizure"},{"key":"ref_48","first-page":"199","article-title":"Deep brain stimulation for epilepsy","volume":"30","author":"Nazzaro","year":"2019","journal-title":"Neurosurg. Clin. N. Am."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1016\/S1353-8020(13)70013-0","article-title":"The functional role of beta oscillations in Parkinson\u2019s disease","volume":"20","author":"Little","year":"2014","journal-title":"Park. Relat. Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1227\/01.NEU.0000097552.31763.AE","article-title":"Bilateral anterior thalamic nucleus lesions and high-frequency stimulation are protective against pilocarpine-induced seizures and status epilepticus","volume":"54","author":"Hamani","year":"2004","journal-title":"Neurosurgery"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.biopsych.2014.11.023","article-title":"A randomized sham-controlled trial of deep brain stimulation of the ventral capsule\/ventral striatum for chronic treatment-resistant depression","volume":"78","author":"Dougherty","year":"2015","journal-title":"Biol. Psychiatry"},{"key":"ref_52","first-page":"3","article-title":"Deep brain stimulation in the treatment of anorexia nervosa: A systematic review","volume":"28","author":"Dalkilic","year":"2023","journal-title":"Eat. Weight Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1212\/WNL.0000000000001334","article-title":"Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy","volume":"84","author":"Salanova","year":"2015","journal-title":"Neurology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1111\/epi.12352","article-title":"Deep brain stimulation of the centromedian thalamic nucleus in the treatment of generalized and frontal epilepsies","volume":"54","author":"Chelvarajah","year":"2013","journal-title":"Epilepsia"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"S83","DOI":"10.1684\/j.1950-6945.2002.tb00549.x","article-title":"Deep brain stimulation in epilepsy with particular reference to the subthalamic nucleus","volume":"4","author":"Chabardes","year":"2002","journal-title":"Epileptic Disord."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1142\/S0129065709001914","article-title":"Neuromodulation of epileptic foci in patients with non-lesional refractory motor epilepsy","volume":"19","author":"Velasco","year":"2009","journal-title":"Int. J. Neural Syst."},{"key":"ref_57","unstructured":"Montgomery, E.B. (2010). Deep Brain Stimulation Programming: Mechanisms, Principles, and Practice, Oxford University Press."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.expneurol.2013.08.017","article-title":"Antidepressant effects after short-term and chronic stimulation of the subgenual cingulate gyrus in treatment-resistant depression","volume":"249","author":"Merkl","year":"2013","journal-title":"Exp. Neurol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.biopsych.2004.11.042","article-title":"Deep brain stimulation for refractory obsessive-compulsive disorder","volume":"57","author":"Abelson","year":"2005","journal-title":"Biol. Psychiatry"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/archgenpsychiatry.2010.122","article-title":"Deep brain stimulation of the nucleus accumbens for treatment-refractory obsessive-compulsive disorder","volume":"67","author":"Denys","year":"2010","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1038\/mp.2008.55","article-title":"Deep brain stimulation of the ventral internal capsule\/ventral striatum for obsessive-compulsive disorder: Worldwide experience","volume":"15","author":"Greenberg","year":"2010","journal-title":"Mol. Psychiatry"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1146\/annurev.neuro.29.051605.112824","article-title":"Deep brain stimulation","volume":"29","author":"Perlmutter","year":"2006","journal-title":"Annu. Rev. Neurosci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1001\/2013.jamaneurol.45","article-title":"History, applications, and mechanisms of deep brain stimulation","volume":"70","author":"Miocinovic","year":"2013","journal-title":"JAMA Neurol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.pneurobio.2005.09.005","article-title":"The functional role of the subthalamic nucleus in cognitive and limbic circuits","volume":"76","author":"Temel","year":"2005","journal-title":"Prog. Neurobiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1111\/j.1528-1167.2010.02536.x","article-title":"Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy","volume":"51","author":"Fisher","year":"2010","journal-title":"Epilepsia"},{"key":"ref_66","first-page":"2144","article-title":"Deep brain stimulation for epilepsy: Current status and future perspectives","volume":"7","author":"Seeck","year":"2011","journal-title":"Rev. Med. Suisse"},{"key":"ref_67","first-page":"179","article-title":"Neuromodulation for epilepsy","volume":"17","author":"Kerrigan","year":"2004","journal-title":"Curr. Opin. Neurol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1631\/jzus.B2300400","article-title":"Wireless closed-loop deep brain stimulation using microelectrode array probes","volume":"12","author":"Jia","year":"2024","journal-title":"J. Zhejiang Univ. Sci. B"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.neubiorev.2013.01.005","article-title":"Neurosurgical targets for compulsivity: What can we learn from acquired brain lesions?","volume":"37","author":"Figee","year":"2013","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1172\/JCI38454","article-title":"Targeted electrode-based modulation of neural circuits for depression","volume":"119","author":"Mayberg","year":"2009","journal-title":"J. Clin. Investig."},{"key":"ref_71","first-page":"16020","article-title":"Directional deep brain stimulation of the medial forebrain bundle: A pilot trial with a novel stimulation device","volume":"2","author":"Coenen","year":"2016","journal-title":"NPJ Parkinsons Dis."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1152\/jn.00275.2015","article-title":"Network effects of deep brain stimulation","volume":"114","author":"Alhourani","year":"2015","journal-title":"J. Neurophysiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"117180","DOI":"10.1016\/j.neuroimage.2020.117180","article-title":"Opportunities of connectomic neuromodulation","volume":"221","author":"Horn","year":"2020","journal-title":"Neuroimage"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Gunalan, K., Chaturvedi, A., Howell, B., Duchin, Y., Lempka, S.F., Patriat, R., Sapiro, G., Harel, N., Johnson, M.D., and Butson, C.R. (2017). Creating and parameterizing patient-specific deep brain stimulation pathway-activation models using the hyperdirect pathway as an example. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0176132"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1093\/jmp\/jhaa020","article-title":"Forty years of the four principles: Enduring themes from Beauchamp and Childress","volume":"45","author":"Shea","year":"2020","journal-title":"J. Med. Philos."},{"key":"ref_76","first-page":"3","article-title":"The \u2018four principles\u2019 approach to health care ethics","volume":"29","author":"Beauchamp","year":"2007","journal-title":"Princ. Health Care Ethics"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s11017-007-9039-8","article-title":"True to oneself? Broad and narrow ideas on authenticity in the enhancement debate","volume":"28","author":"Bolt","year":"2007","journal-title":"Theor. Med. Bioeth."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/21507740.2017.1320320","article-title":"Staying in the Loop: Relational Agency and Identity in Next-Generation DBS for Psychiatry","volume":"8","author":"Goering","year":"2017","journal-title":"AJOB Neurosci."},{"key":"ref_79","unstructured":"Smeding, H.M.M. (2008). Neuropsychological Effects of Subthalamic Nucleus Stimulation in Parkinson Disease. [Doctoral Dissertation, University of Amsterdam]."},{"key":"ref_80","first-page":"71","article-title":"Dimensions of the threat to the self posed by deep brain stimulation: Personal identity, authenticity, and autonomy","volume":"18","author":"Zawadzki","year":"2021","journal-title":"Diametros"},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Beeker, T., Schlaepfer, T.E., and Coenen, V.A. (2017). Autonomy in depressive patients undergoing DBS treatment: Informed consent, freedom of will and DBS\u2019 potential to restore it. Front. Integr. Neurosci., 11.","DOI":"10.3389\/fnint.2017.00011"},{"key":"ref_82","first-page":"309","article-title":"Towards optimizing closed-loop deep brain stimulation: A computational approach","volume":"7","author":"Noecker","year":"2014","journal-title":"Brain Stimul."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1109\/TBCAS.2018.2880148","article-title":"A chronically implantable neural coprocessor for investigating the treatment of neurological disorders","volume":"12","author":"Stanslaski","year":"2018","journal-title":"IEEE Trans. Biomed. Circuits Syst."},{"key":"ref_84","first-page":"94","article-title":"Neuromodulation: Devices, technology, and the future","volume":"10","author":"Herron","year":"2020","journal-title":"Brain Sci."},{"key":"ref_85","first-page":"117643","article-title":"Health-related quality of life in hemato-oncology patients: Role of informativeness and doctor\u2013patient communication","volume":"12","year":"2024","journal-title":"Health Psychol. Res."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/10\/158\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:47:11Z","timestamp":1759420031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/10\/158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,2]]},"references-count":85,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["neurolint17100158"],"URL":"https:\/\/doi.org\/10.3390\/neurolint17100158","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,2]]}}}