TY  - JOUR
PY  - 2022//
TI  - Deep brain stimulation for severe and intractable aggressive behavior
JO  - Stereotactic and functional neurosurgery
A1  - Escobar Vidarte, Oscar Andrés
A1  - Griswold, Dylan Paul
A1  - Orozco Mera, Javier
A1  - Arango Uribe, Gabriel José
A1  - Salcedo, Juan Camilo
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - Aggressive behavior in patients with intellectual disability can be resistant to pharmacological treatment and have detrimental consequences to themselves, family members, and caregivers. Hypothalamic deep brain stimulation (DBS) has been used to improve this type of behavior in severe and refractory cases. Here, we present the description and analysis of DBS of the posteromedial hypothalamus (PMH) and its long-term impact as treatment to improve severe and refractory aggressive behaviors, even with previous bilateral hypothalamotomy without improvement in patients with intellectual disability. Eleven patients underwent bilateral DBS of the PMH. Their medical records were reviewed, and the impact on behavior was measured using preoperative and postoperative Modified Overt Aggression Scale (MOAS) during the last follow-up medical visit. Nine of 11 patients presented a significant decrease in the severity of aggressive behavior, with a preoperative and postoperative MOAS average value of 50.5 and 18.7, respectively. An overall improvement of 63% was seen with a mean follow-up time of 4 years. A patient who previously underwent a bilateral hypothalamotomy via radiofrequency was included in this group. During follow-up, 3 patients presented deterioration of symptoms subsequent to pulse generator depletion but made a full clinical recovery after battery replacement. We posit that DBS of the PMH may be a safe and effective in improving severe and refractory aggressive behavior in patients with long-term intellectual disability.<p />  <p>Language: en</p>
LA  - en
SN  - 1011-6125
UR  - http://dx.doi.org/10.1159/000521766
ID  - ref1
ER  -