Deep Brain Stimulation for Parkinson's Disease During the COVID-19 Pandemic: Patient Perspective

Public Perceptions of Neurotechnologies Used to Target Mood, Memory, and Motor Symptoms

Background

Advances in the development of neurotechnologies have the potential to revolutionize treatment of brain-based conditions. However, a critical concern revolves around the willingness of the public to embrace these technologies, especially considering the tumultuous histories of certain neurosurgical interventions. Therefore, examining public attitudes is paramount to uncovering potential barriers to adoption ensuring ethically sound innovation.

Methods

In the present study, we investigate public attitudes towards the use of four neurotechnologies (within-subjects conditions): deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), pills, and MRI-guided focused ultrasound (MRgFUS) as potential treatments to a person experiencing either mood, memory, or motor symptoms (between-subjects conditions). US-based participants (N=1052; stratified to be nationally representative based on sex, race, age) were asked about their perceptions of risk, benefit, invasiveness, acceptability, perceived change to the person, and personal interest in using these neurotechnologies for symptom alleviation.

Results

Descriptive results indicate variability between technologies that the U.S. public is willing to consider if experiencing severe mood, memory, or motor symptoms. The main effect of neurotechnology revealed DBS was viewed as the most invasive and risky treatment and was perceived to lead to the greatest change to who someone is as a person. DBS was also viewed as least likely to be personally used and least acceptable for use by others. When examining the main effects of symptomatology, we found that all forms of neuromodulation were perceived as significantly more beneficial, acceptable, and likely to be used by participants for motor symptoms, followed by memory symptoms, and lastly mood symptoms. Neuromodulation (averaging across neurotechnologies) was perceived as significantly riskier, more invasive, and leading to a greater change to person for mood versus motor symptoms; however, memory and motor symptoms were perceived similarly with respect to risk, invasiveness, and change to person.

Conclusion

These results suggest that the public views neuromodulatory approaches that require surgery (i.e., DBS and MRgFUS) as riskier, more invasive, and less acceptable than those that do not. Further, findings suggest individuals may be more reluctant to alter or treat psychological symptoms with neuromodulation compared to physical symptoms.

Preventing the Growing Transmission of COVID Clusters: An Integration of the Maslow's Hierarchy of Needs in the Risk Chain

PURPOSE

China's success in containing the coronavirus is an ongoing process of identifying loopholes and refining the management in the COVID-19 risk chain. This article discusses the role of personal needs in epidemic control and linked psychological needs with management measures to propose intervention advice on curbing viral transmission in a systematic way.

METHODS

Based on case studies, we showed the integration of the Maslow's Hierarchy of Needs in the COVID-19 risk chain. The analysis combined the micro-view from individual needs and macro influences from governmental measures. The proposed chain of vulnerabilities could help identify critical links of COVID-19 crisis management in case that cascading effects such as super-spread can be intercepted in time.

RESULTS

The article mainly focused on curbing the viral transmission timely whenever cluster of cases resurge. Considering the triggered activities from personal needs may facilitate the spread, minimizing the impact scale while managing the crisis could start with protecting vulnerable population, well governing potential hotspots, and necessary restrictions on group activities. Besides, "individual" protections combined with "institutional" solutions are strongly advocated. The worst scenario would be the governance link slackened or made mistakes, together with delayed identification, plus unprotected way of living and gathering. In order to cut the transmission in time, besides virus-blocking strategies and vaccination approach, screening measures in combination with the satisfaction of personal needs would help identify confirmed cases earlier. Publicizing the model citizen of being responsible could show needs' satisfaction can live with the virus elimination. At the emergency response stage, it is also crucial to secure fewer loopholes in the health system and strengthen the self-protection barrier by all means.

CONCLUSION

China's experience offers a reference for the balance between the resurgence of clustered cases and sustained recovery. As long as the global pandemic continues, its impact on personal activities will not stop, and vice versa. The chain of vulnerabilities integrating psychological needs into the COVID-19 risk management can provide clear clues for cutting further transmission in an efficient and more socially acceptable way.