Deep Brain Stimulation: Inducing Self-Estrangement
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ORIGINAL PAPER
Deep Brain Stimulation: Inducing Self-Estrangement Frederic Gilbert
Received: 22 November 2016 / Accepted: 4 May 2017 # Springer Science+Business Media Dordrecht 2017
Abstract Despite growing evidence that a significant number of patients living with Parkison’s disease experience neuropsychiatric changes following Deep Brain Stimulation (DBS) treatment, the phenomenon remains poorly understood and largely unexplored in the literature. To shed new light on this phenomenon, we used qualitative methods grounded in phenomenology to conduct in-depth, semi-structured interviews with 17 patients living with Parkinson’s Disease who had undergone DBS. Our study found that patients appear to experience postoperative DBS-induced changes in the form of self-estrangement. Using the insights from patients’ subjective perceptions of postoperative selfchange provides a potent explanation of potential DBS-induced self-estrangement. Keywords Deep brain stimulation . Estrangement . Identity . Neuropsychiatric effects . Parkinson’s disease . Personality . Phenomenology . Responsibility . Self . Self-report
Background The non-targeted effects of Deep Brain Stimulation (DBS)‘s are an important phenomenon to be understood given that the number of patients who have been F. Gilbert (*) Center for Sensorimotor Neural Engineering, Department of Philosophy, University of Washington, Seattle, WA, USA e-mail: [email protected]
implanted with an approved therapy is now more than 135,000 [1]. Non-target effects, such as neuropsychiatric changes following DBS treatment remain poorly understood and are virtually absent from discussions in the literature, despite growing evidence that a significant number of patients experience these phenomena [2–5]. To our knowledge, only a small number of studies have specifically addressed postoperative neuropsychiatric changes in terms of potential phenomenological developments—that is to say, at the level of the patient’s subjective experience of being implanted with DBS [6–11]. To address the dearth of first hand evidence regarding potential phenomenon of DBS-induced changes, we used qualitative methods grounded in phenomenology to conduct interviews with 17 patients implanted with DBS who were living with Parkinson’s Disease. This manuscript: 1) highlights the objective; 2) presents methods; 3) reports findings and 4) discusses, defines and examines the notion of potential DBSinduced self-estrangement in light of our findings.
Objective Our aim was to explore first-personal accounts of perceived self-change by patients implanted with DBS.1 Through an analysis of the qualitative data, this study also aimed at gaining further knowledge about a potential DBS-induced phenomenon; in particular with respect of feeling of postoperative self-estrangement. 1
This study expands upon some hypotheses that were initially sketched in [12].
F. Gilbert
Previous studies have observed that some patients suffering from postoperative self-changes were at greater risk of harm, including, for inst
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