Our next study group/ expert meeting philosophy & psychiatry will be held on Friday June 20th in Nijmegen. We will convene in room E. 15.39/41 (Erasmus building on the RU campus, Erasmusplein 1). We will start at 3 pm, as usual.

Maarten van Westen (AMC) and Erik Rietveld (UvA/AMC) will give a presentation on their new project:

‘Towards evidence-based optimization of Deep Brain Stimulation parameter settings in psychiatric disorders’:

Deep Brain Stimulation (DBS) is used to treat selected patients with obsessive-compulsive disorder (OCD), who did not improve on psychotherapy and medication. This invasive neuromodulation therapy has been proven effective in 60% of these patients. The DBS, as an electrical device, can be manipulated with regard to amplitude, pulse-width and frequency of stimulation, which happens on the basis of reported experience, expressions and activities of the patient. Crucially, there are thousands of potential parameter settings. The current optimization methodology is practice driven depending on the experience of a limited number of experts, being ‘more art than science’. To date, there is no consensus on DBS-optimization methodology and no protocol that describes a standardized and verified method of achieving optimal symptom improvement and side-effect-suppression. Our aim is to explicate and improve the practice of DBS-parameter setting optimization, and to propose a protocol. We will use an enactive affordance-based theoretical framework in accordance with the central claims of Rietveld’s VIDI-project. It enables us to analyze both expert intuition and the experience of the patient in a flexible and context-sensitive way, so that our protocol can account for the phenomenological changes that were observed by de Haan et al 2013, which are currently not covered by the widely used Yale-Brown Obsessive Compulsive Scale (YBOCSS).