New Directions

The Hippocampus and Nucleus Accumbens as Potential Therapeutic Targets for Neurosurgical Intervention in Schizophrenia
Charles B. Mikell, Guy M. McKhann, Solomon Segal, Robert A. McGovern, Matthew B. Wallenstein, Holly Moore

Department of Neurological Surgery, Columbia University, New York, N.Y., USA

Address of Corresponding Author

Stereotact Funct Neurosurg 2009;87:256-265 (DOI: 10.1159/000225979)

  Key Words

• Deep brain stimulation
• Schizophrenia
• Neurostimulation
• Hippocampus
• Nucleus accumbens
• Dopamine
• Psychosis

  Abstract

Schizophrenia is a chronic and disabling psychiatric illness that is often refractory to treatment. Psychotic symptoms (e.g. hallucinations and delusions) in schizophrenia are reliably correlated with excess dopamine levels in the striatum, and have more recently been related to excess metabolic activity in the hippocampus. Multiple lines of evidence suggest that aberrantly high hippocampal activity may, via hippocampal connections with the limbic basal ganglia, drive excessive dopamine release into the striatum. In the present paper, we hypothesize that inhibition or stabilization of neural activity with high-frequency electrical stimulation of the hippocampus or nucleus accumbens, through different mechanisms, would treat the positive symptoms of schizophrenia. Thus, we suggest a direction for further experimentation aimed at developing neurosurgical therapeutic approaches for this devastating disease.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Holly Moore, PhD
Columbia University, Department of Psychiatry
1051 Riverside Dr., Mail Unit 14
New York, NY 10032 (USA)
Tel. +1 212 543 6938, Fax +1 212 543 1017, E-Mail hm2035@columbia.edu

  Article Information

Published online: June 26, 2009
Number of Print Pages : 10
Number of Figures : 2, Number of Tables : 0, Number of References : 84