More on DBS (and the Neurological/Psychiatric Divide)

"The microdrive behind the sterile curtain will insert probes into my brain a few micrometers at a time." - Steven Gulie in Wired

It seems that deep brain stimulation is in the news these days, particularly DBS for Parkinson's disease. Neurophilosophy (A first-hand account of deep brain stimulation) and Mind Hacks (Deep brain electrodes - from the inside) have covered an article in Wired written by a patient undergoing the procedure at Stanford University:

A Shock to the System

To slow the progress of Parkinson’s disease, doctors planted electrodes deep in my brain. Then they turned on the juice.

By Steven Gulie

I'm lying in an operating room at the Stanford University hospital, head shaved, waiting for my brain surgery to begin. Sure, I feel anxious, but mostly I feel crowded. There are 10 people milling about, tinkering with instruments and examining me. It’s an impressive crew, including a neurosurgeon and his fellow, a neurologist and her fellow, an anesthesiologist, an experimental physicist, and a graduate student in electrical engineering. That’s right, a physicist and an electrical engineer. Directly behind me, out of my sight, is the star of the show, chief neurosurgeon Jaimie Henderson: 44 years old, tall, erudite, and handsome. On my right, flexing my hands, is neurologist Helen Bronte-Stewart: brisk, smart, and beautiful. In fact, nearly everyone is not only brilliant but also pretty enough to play themselves in the movie version of this story. I call them Team Hubris.

The procedure has been remarkably successful, allowing most patients to resume their normal activities after being held captive by tremors, rigidity, and bradykinesia for years:

Today, eight years since the first signs of Parkinson’s and after months of fiddling, my body is almost free of symptoms. With the stimulator turned off, a Parkinson’s test shows 20 significant impairments. With the stimulator on, it drops to two. Add just a touch of L-dopa and it drops to zero.

The last wisps of fog have cleared away. My jokes make people laugh again. I can keep up with conversation. I can ride a bike. I can write. It’s been five months since the surgery, but it has finally all come together: It works. I forget that I even have Parkinson’s most of the time. And last November, I went back to work full-time. It’s a miracle. A second chance at life.

DBS isn't limited to Parkinson's, however. The Neurocritic has previously covered DBS for severe intractable depression and phantom limb pain.

To my knowledge, there have been no protests about conducting invasive brain surgery on people with neurological disorders such as Parkinson's, primary generalised dystonia, atypical tremor syndromes, and epilepsy. However, when the same general procedure (with different neural targets, of course) is used for a psychiatric disorder, rabid virulent critics crawl out of the woodwork to call the procedure "butchery" and those who discuss it "disgusting misguided butchers" (among other unmentionable names).

How about Tourette's Syndrome? Neurophilosophy discussed Deep brain stimulation for Tourette's Syndrome and didn't get any nasty comments from anti-psychiatry trolls. Perhaps that's because Tourette's is now considered an inherited neurological disorder (in most cases), although it had previously been classified as a "psychiatric" disorder, as summarized in this Science commentary:

The cause of Tourette syndrome has been controversial ever since Georges Gilles de la Tourette, a neurologist who shared a mentor with Sigmund Freud at the Salpêtrière Hospital in Paris, first described the condition in 1885. Is the syndrome the result of hysteria (Tourette’s hypothesis), repressed sexual conflicts, or oppressive mothers, which were the favored explanations for much of the 20th century? Or is it an organic defect of the brain, as many neuroscientists and physicians now hold? The ability of neuroleptic drugs, beginning with haloperidol in the 1960s, to reduce tics supported the neurologic position.

Or maybe it's just because DBS for TS hasn't gotten the publicity that DBS for depression has received...