“The heart asks pleasure first” - conceptualizing psychiatric diseases as MAINTENANCE network dysfunctions through insights from slMFB DBS in depression and obsessive–compulsive disorder

Abstract: More than a decade ago, deep brain stimulation (DBS) of the superolateral medial forebrain bundle (slMFB), as part of the greater MFB system, had been proposed as a putative yet experimental treatment strategy for therapy refractory depression (TRD) and later for obsessive–compulsive disorders (OCD). Antidepressant and anti-OCD efficacy have been shown in open case series and smaller trials and were independently replicated. The MFB is anato-physiologically confluent with the SEEKING system promoting euphoric drive, reward anticipation and reward; functions realized through the mesocorticolimbic dopaminergic system. Growing clinical experience concerning surgical and stimulation aspects from a larger number of patients shows an MFB functionality beyond SEEKING and now re-informs the scientific rationale concerning the MFB’s (patho-) physiology. In this white paper, we combine observations from more than 75 cases of slMFB DBS. We integrate these observations with a selected literature review to provide a new neuroethological view on the MFB. We here formulate a re-interpretation of the MFB as the main structure of an integrated SEEKING/MAINTENANCE circuitry, allowing for individual homeostasis and well-being through emotional arousal, basic and higher affect valence, bodily reactions, motor programing, vigor and flexible behavior, as the basis for the antidepressant and anti-OCD efficacy

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• Standort: Deutsche Nationalbibliothek Frankfurt am Main
• Umfang: Online-Ressource
• Sprache: Englisch
• Anmerkungen: Brain sciences. - 12, 4 (2022) , 438, ISSN: 2076-3425

Beteiligte, Orts- und Zeitangaben

• Ereignis: Veröffentlichung
• (wo): Freiburg
• (wer): Universität
• (wann): 2022
• Urheber: Coenen, Volker Arnd ; Schläpfer, Thomas ; Sajonz, Bastian ; Reinacher, Peter ; Döbrössy, Máté D. ; Reisert, Marco

Weitere Informationen

• DOI: 10.3390/brainsci12040438
• URN: urn:nbn:de:bsz:25-freidok-2260816
• Rechteinformation: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.