The Effectiveness of Deep Brain Stimulation for Opioid Relapse Prevention

The Effectiveness of Deep Brain Stimulation for Opioid Relapse Prevention

The nucleus accumbens (NAcc) has a significant role in the process of opiate addiction and the initiation of relapse after detoxification. There is evidence that deep brain stimulation (DBS) of the NAcc exerts a positive effect on individuals with severe heroin addiction via inhibitory action .

The investigators hypothesise that bilateral stimulation of the NAcc will significantly reduce withdrawal symptoms and thus enable the patients to substantially decrease their Levomethadone usage.

Inclusion Criteria:

• Proficiency in Mandarin language
• Long lasting heroin addiction (determined by diagnostic-criteria in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition)
• Duration longer than 6 months
• A lack of response to long-term treatment
• Capacity to provide informed consent (understanding of the study purpose and methods)
• Substitution methadone treatment at a constant dose within three months prior to inclusion.

Exclusion Criteria:

• Clinical relevant psychiatric comorbidity (schizophrenic psychoses, bipolar affective diseases with psychotic symptoms)(MINI 6.0)
• Past stereotactic neurosurgical intervention
• Neurological disease (Abnormal PET-CT, MRI, EEG)
• Contraindications of MRI-examination, e.g. implanted cardiac pacemaker/ heart defibrillator
• Contraindications of stereotactic intervention, e.g. increased bleeding-disposition, cerebrovascular diseases (e.g. arteriovenous malfunction, aneurysms, systemic vascular diseases)
• Serious and unstable organic diseases (e.g. unstable coronal heart disease)
• HIV positive
• Pregnancy and/or lactation