China takes the lead in testing deep brain stimulation for drug addiction as critics raise ethical concerns. [
Dr. Li Dianyou uses a tablet computer to adjust the settings of a deep brain stimulation device implanted in the brain of a methamphetamine user named Yan, left, on Monday, Oct. 29, 2018, at Ruijin Hospital in Shanghai, China. Western attempts to push forward with human trials of DBS for drug addiction have foundered, even as China has emerged as a hub for this kind of research. But the vast suffering wrought by the U.S. opioid epidemic may be changing the risk-reward calculus.
The treatment — deep brain stimulation — has long been used for movement disorders like Parkinson’s. Now, the first clinical trial of DBS for methamphetamine addiction is being conducted at Shanghai’s Ruijin Hospital, along with parallel trials for opioid addiction. And this troubled man is the very first patient.
But the suffering wrought by the opioid epidemic may be changing the risk-reward calculus for doctors and regulators in the United States. Now, the experimental surgery Patient Number One is about to undergo is coming to America. In February, the U.S. Food and Drug Administration greenlighted a clinical trial in West Virginia of DBS for opioid addiction.Patient Number One insisted that only his surname, Yan, be published; he fears losing his job if he is identified.
Last year his father, who had a friend who had undergone DBS surgery at Ruijin, gave him an ultimatum: Back to rehab or brain surgery. “Of course, I chose surgery,” Yan said. “With surgery, I definitely have the chance to get my life back.” “As doctors we always need to think about the patients,” said Dr. Sun Bomin, director of Ruijin Hospital’s functional neurosurgery department. “They are human beings. You cannot say, ‘Oh, we do not have any help, any treatment for you guys.’”
The failure of two large-scale, U.S. clinical trials on DBS for depression around five years ago prompted soul-searching about what threshold of scientific understanding must be met in order to design effective, ethical experiments. At least two U.S. laboratories dropped clinical trials of DBS for treating alcoholism over concerns about study design and preliminary results that didn’t seem to justify the risks, investigators who led the studies told The Associated Press.
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