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Prof. Damiaan Denys

Damiaan Denys psiquiatra Controversies Psiquiatria Barcelona
Universiteit van Amsterdam, Països Baixos
Ponència Estimulació cerebral personalitzada en psiquiatria
Data Dijous, 20 d'abril, 2023
Hora 18:45 - 19:30
Taula rodona 1 Neuromodulació de precisió en trastorns psiquiàtrics: de les teràpies antigues a les noves

BIOGRAFIA

Damiaan Denys is professor and chair of the Department of Psychiatry (AmsterdamUMC) at the University of Amsterdam (UVA) in The Netherlands. He studied Philosophy and Medicine at the University of Leuven. His scientific research is characterized by a translational approach, making use of clinical psychiatry, philosophy and fundamental neurosciences. A particular focus of his research is the development of deep brain stimulation (DBS) for psychiatric disorders. Prof. Denys has published over 500 peer-reviewed articles and has an H-index of 80 (Google Scholar). He has received numerous awards including the IgNobel prize (2020) for his characterisation of Misophonia.

https://scholar.google.es/scholar?hl=ca&as_sdt=0%2C5&q=Damiaan+Denys&btnG=

RESUM

Deep brain stimulation is a promising treatment for neuropsychiatric conditions such as obsessive compulsive disorder and major depression. Deep brain stimulation for severe, treatment-resistant psychiatric disorders has moved in the past twenty years from empiricism to scientific evidence. Current drivers of this transition are advances in neuroimaging and neurophysiology. As we understand more about the neural basis of these disorders, we will more successfully be able to use DBS to restore dysfunctional circuits to health. At the group-level, deep brain stimulation leads to significant therapeutic benefit in a multitude of neurological and neuropsychiatric disorders. At the single-patient level, however, symptoms may persist despite “optimal” electrode placement at established treatment coordinates. This may be partly explained by limitations of disease-centric strategies that are unable to account for heterogeneous phenotypes and comorbidities observed in clinical practice. Instead, tailoring electrode placement and programming to individual patients’ symptom profiles may increase the fraction of responding patients. Personalized interventions for people suffering from psychiatric conditions at all stages of illness have seen an evolution in the past few years, from genomic-based subtyping1and imaging-based subtyping2 for the optimization of first-line treatment selection to new methods for individualized image-guided targeting. With closed loop stimulation, DBS could be optimized by identifying neural biomarkers that trigger therapy selectively when symptom severity is elevated. Although precision psychiatry, it does not meet the criteria of personalised psychiatry.

REFERÈNCIES

[Full apper] Fridgeirsson EA, ..., Denys D. (2023). Patient specific intracranial neural signatures of obsessions and compulsions in the ventral striatum. J Neural Eng. 2023 Mar 10;20(2). doi: 10.1088/1741-2552/acbee1. PMID: 36827705.

[PDF] Graat I, ..., Denys D. (2022). Tractography-based versus anatomical landmark-based targeting in vALIC deep brain stimulation for refractory obsessive-compulsive disorder. Mol Psychiatry. 2022 Dec;27(12):5206-5212. doi: 10.1038/s41380-022-01760-y. Epub 2022 Sep 7. PMID: 36071109.

[Full paper] Denys D, et al (2020). Efficacy of Deep Brain Stimulation of the Ventral Anterior Limb of the Internal Capsule for Refractory Obsessive-Compulsive Disorder: A Clinical Cohort of 70 Patients. Am J Psychiatry. 2020 Mar 1;177(3):265-271. doi: 10.1176/appi.ajp.2019.19060656. Epub 2020 Jan 7. PMID: 31906709.