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Brain Sci. 2018, 8(5), 84; https://doi.org/10.3390/brainsci8050084

Informed Consent Decision-Making in Deep Brain Stimulation

1
Department of Human Neurosciences (Former Department of Neurology and Psychiatry), “Sapienza” University of Rome, 00185 Rome, Italy
2
Department of Mental Health, ASL Roma 5, 00034 Colleferro, Italy
*
Author to whom correspondence should be addressed.
Received: 2 May 2018 / Revised: 7 May 2018 / Accepted: 8 May 2018 / Published: 11 May 2018
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Abstract

Deep brain stimulation (DBS) has proved useful for several movement disorders (Parkinson’s disease, essential tremor, dystonia), in which first and/or second line pharmacological treatments were inefficacious. Initial evidence of DBS efficacy exists for refractory obsessive-compulsive disorder, treatment-resistant major depressive disorder, and impulse control disorders. Ethical concerns have been raised about the use of an invasive surgical approach involving the central nervous system in patients with possible impairment in cognitive functioning and decision-making capacity. Most of the disorders in which DBS has been used might present with alterations in memory, attention, and executive functioning, which may have an impact on the mental capacity to give informed consent to neurosurgery. Depression, anxiety, and compulsivity are also common in DBS candidate disorders, and could also be associated with an impaired capacity to consent to treatment or clinical research. Despite these issues, there is limited empirical knowledge on the decision-making levels of these patients. The possible informed consent issues of DBS will be discussed by focusing on the specific treatable diseases. View Full-Text
Keywords: informed consent; decision-making capacity; deep brain stimulation informed consent; decision-making capacity; deep brain stimulation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Mandarelli, G.; Moretti, G.; Pasquini, M.; Nicolò, G.; Ferracuti, S. Informed Consent Decision-Making in Deep Brain Stimulation. Brain Sci. 2018, 8, 84.

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