Sakas Damianos E, Panourias Ioannis G
Unit of Functional Neurosurgery, Department of Neurosurgery, University of Athens Medical School, Evangelismos Hospital, 4, Marasli Street, 10676 Athens, Greece.
Med Hypotheses. 2006;66(3):491-4. doi: 10.1016/j.mehy.2005.07.036. Epub 2005 Dec 7.
Surgery for intractable affective illnesses has generated considerable controversy over the last century. Deep brain stimulation (DBS) has revolutionized neurosurgical practice, especially in the field of advanced Parkinson's disease and, more recently, in selected medical-refractory cases of obsessive-compulsive disorder. In this paper, we propose a discrete area of the rostral cingulate gyrus as a potential target for DBS in medical-resistant depressive patients. Brodmann's area 24a has proved to be a vital link in the integration of neural circuits underlying depression, both through proposed neurobiological models and accurate neuroimaging studies. The full reversibility and adjustability of DBS offer the best chance to treat the multidimensional and life-span profile of depression, so giving hope to a great number of desperate human beings.
在过去的一个世纪里,针对难治性情感疾病的手术引发了相当大的争议。深部脑刺激(DBS)彻底改变了神经外科手术实践,尤其是在晚期帕金森病领域,以及最近在某些药物难治性强迫症病例中。在本文中,我们提出将喙扣带回的一个离散区域作为药物抵抗性抑郁症患者DBS的潜在靶点。通过提出的神经生物学模型和精确的神经影像学研究,布罗德曼24a区已被证明是抑郁症潜在神经回路整合中的关键环节。DBS的完全可逆性和可调节性为治疗抑郁症的多维度和终生特征提供了最佳机会,从而给众多绝望的人带来了希望。