Deep Brain Stimulation to Understand and Treat Addiction

Exclusion Criteria26

• Severe psychiatric disorder other than Alcohol Use Disorder (e.g., schizophrenia, schizoaffective disorder, bipolar disorder)
• Severe major depressive disorder (moderate depression acceptable)
• Current active suicidal ideation or history of serious suicide attempts
• Previous treatment with electroconvulsive therapy (ECT)
• Presence of implanted electrical devices, including:
• Cardiac pacemaker or defibrillator (or clinical indication for pacemaker placement)
• Implanted vagus nerve stimulator (VNS)
• Any other chronically implanted neurostimulation device
• Significant neurological history, including prior hemorrhagic or ischemic stroke, subarachnoid hemorrhage, or other major neurological illness
• Any significant medical condition that, in the opinion of the clinical team, would increase surgical or anesthetic risk
• Current pregnancy
• Contraindications to deep brain stimulation or neurosurgery, including:
• Inability to tolerate general anesthesia (as assessed by anesthesiology)
• Increased risk of bleeding (as determined by hepatology/hematology review)
• History of coagulopathy
• Current or previous anticoagulant use
• Uncontrolled hypertension (controlled hypertension with medication is acceptable)
• Stage 4 liver cirrhosis
• History of major cardiac arrhythmia (e.g., atrial fibrillation) or need for anti-arrhythmic medication
• History of requiring cardioversion
• History of repeated falls
• History of major head injury
• Marked cognitive impairment
• Seizure history, including multiple alcohol withdrawal seizures
• Marked cortical atrophy on neuroimaging
• Inadequate logistical or social support that would impair the safe conduct of deep brain stimulation therapy, including inability to reliably attend scheduled visits, lack of reasonable access to the study site, or inadequate home or caregiver support necessary for postoperative care, device management and follow-up.