Frontiers in Psychiatry (May 2023)

A single case report of STN-DBS for severe crack-cocaine dependence: double-blind ON vs. SHAM randomized controlled assessment

  • Florence Vorspan,
  • Florence Vorspan,
  • Philippe Domenech,
  • Philippe Domenech,
  • David Grabli,
  • David Grabli,
  • Jérôme Yelnik,
  • Marine Delavest,
  • Charles Dauré,
  • Frank Bellivier,
  • Frank Bellivier,
  • Antoine Pelissolo,
  • Antoine Pelissolo,
  • Hayat Belaid,
  • Christelle Baunez,
  • Carine Karachi,
  • Carine Karachi,
  • Luc Mallet,
  • Luc Mallet,
  • Luc Mallet

DOI
https://doi.org/10.3389/fpsyt.2023.1146492
Journal volume & issue
Vol. 14

Abstract

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Crack-cocaine dependence is a severe condition with a high mortality rate. This single case study report details the first deep brain stimulation (DBS) trial targeting the sub-thalamic nucleus (STN) for crack-cocaine dependence. The investigation aimed to assess the effects of STN-DBS on cocaine craving and cocaine use, as well as STN-DBS safety and tolerance in this indication. In this pilot study, we performed double blind cross-over trials, with “ON-DBS” vs. “SHAM-DBS” for 1-month periods. STN-DBS failed to reduce cocaine craving and use. An episode of DBS-induced hypomania occurred after several weeks of cocaine intake at stimulation parameters previously well tolerated. Future research on cocaine dependence should be conducted after a prolonged abstinence period and/or explore novel types of stimulation patterns.

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