Functional Neuroanatomy of Secondary Self-Injurious Behavior
Peeters S, Skoch J, Holt H, Mubita L, Choudhary EA, Vadivelu KP, Gilbert DL, Wu SW, Keebaugh AC, Air E, and Vadivelu S. Functional neuroanatomy of secondary self-injurious behavior. Pediatr Neurosurg 2018; 53(2):71-80.
BACKGROUND: Secondary self-injurious behavior (SSIB) is underreported and predominantly not associated with suicide. In both adults and children, SSIB can cause intractable self-harm and is associated with a variety of clinical disorders, particularly those involving dysfunctional motor control.
METHODS: We performed a literature review evaluating the clinical efficacy of deep-brain stimulation (DBS) as modulating SSIB observations and review current progress in preclinical SSIB animal studies.
RESULTS: Neuromodulation is an effective therapeutic option for several movement disorders. Interestingly, this approach is emerging as a potentially effective treatment for movement disorder-associated SSIB (secondary); however, it is important to understand the neuroanatomy, clinical appraisal, and outcome data when considering surgical therapy for SSIB.
CONCLUSION: The current review examines the literature encompassing animal models and human case studies while identifying existing hypotheses from cytoarchitectonic-based targeting to neurotransmitter-based pathways. This review also highlights the need for awareness of an underrecognized pathology that may be amenable to DBS.
Medical Subject Headings
Animals; Basal Ganglia; Brain; Deep Brain Stimulation; Humans; Mental Disorders; Movement Disorders; Neuroanatomy; Pediatrics; Self-Injurious Behavior