Fukaya Chikashi
Department of Neurological Surgery, Nihon University School of Medicine, Japan.
No Shinkei Geka. 2007 Apr;35(4):391-9.
The effects of electrical stimulation on the nervous system have been known for many years. Electrical stimulation has been employed as a treatment of functional diseases of the nervous system and has been mainly developed on the basis of deep brain stimulation (DBS), motor cortex stimulation (MCS), and spinal cord stimulation (SCS). Over the past two decades, DBS has replaced lesioning techniques as a treatment for movement disorders, and DBS has been shown to be safe and efficacious. The field of application for DBS is becoming wider, currently encompassing dystonias, epilepsy, and psychiatric disease. On the other hand, MCS has been employed as a therapy for intractable pain for more than ten years. Recently, this therapy has been used as a treatment for involuntary movements and motor palsy caused by stroke. Although the effects of electrical stimulation are distinct and the therapeutic benefits are well recognized, the exact mechanisms of these therapies have not yet been fully clarified. Animal experiments, either in vitro or in vivo, show complex patterns roughly suggesting inhibitory effects. More recent data from in vitro biological research studies show that electrical stimulation affects cellular functions, particularly protein synthesis, suggesting that it could alter synaptic transmission and reorganize neural networks. Research for the understanding of the effects of electrical stimulation at the neuronal level is still in progress, and knowledge from these research will eventually improve the effectiveness of this therapy. Moreover, these basic research and preliminary clinical studies will call for the re-examination of the basic effects of electricity on living tissues because it is now clear that electrical stimulation has a wider application. In this review, we summarizes the history and rationale behind electrical neurostimulation therapy and the recent applications of this technique for various functional diseases of the nervous system.
电刺激对神经系统的影响已为人所知多年。电刺激已被用作治疗神经系统功能性疾病的方法,并且主要是在深部脑刺激(DBS)、运动皮层刺激(MCS)和脊髓刺激(SCS)的基础上发展起来的。在过去的二十年中,DBS已取代毁损技术成为治疗运动障碍的方法,并且已证明DBS是安全有效的。DBS的应用领域正在不断扩大,目前涵盖了肌张力障碍、癫痫和精神疾病。另一方面,MCS已被用作治疗顽固性疼痛的方法已有十多年。最近,这种疗法已被用于治疗中风引起的不自主运动和运动性麻痹。尽管电刺激的效果明显且治疗益处得到广泛认可,但其确切机制尚未完全阐明。体外或体内的动物实验显示出大致表明具有抑制作用的复杂模式。来自体外生物学研究的最新数据表明,电刺激会影响细胞功能,特别是蛋白质合成,这表明它可能会改变突触传递并重组神经网络。对电刺激在神经元水平上的作用机制的研究仍在进行中,这些研究获得的知识最终将提高这种疗法的有效性。此外,这些基础研究和初步临床研究将促使人们重新审视电对活组织的基本作用,因为现在很明显电刺激具有更广泛的应用。在这篇综述中,我们总结了电神经刺激疗法的历史和原理,以及该技术在神经系统各种功能性疾病中的最新应用。