Sudhyadhom Atchar, Bova Frank J, Foote Kelly D, Rosado Christian A, Kirsch-Darrow Lindsey, Okun Michael S
Department of Neurology, McKnight Brain Institute, 100 South Newell Drive, Gainesville, FL 32610, USA.
Curr Neurol Neurosci Rep. 2007 Jul;7(4):278-89. doi: 10.1007/s11910-007-0043-1.
The use of deep brain stimulation (DBS) has recently been expanding for the treatment of many neurologic disorders such as Parkinson disease, dystonia, essential tremor, Tourette's syndrome, cluster headache, epilepsy, depression, and obsessive compulsive disorder. The target structures for DBS include specific segregated territories within limbic, associative, or motor regions of very small subnuclei. In this review, we summarize current clinical techniques for DBS, the cognitive/mood/motor outcomes, and the relevant neuroanatomy with respect to functional territories within specific brain targets. Future development of new techniques and technology that may include a more direct visualization of "motor" territories within target structures may prove useful for avoiding side effects that may result from stimulation of associative and limbic regions. Alternatively, newer procedures may choose and specifically target non-motor territories for chronic electrical stimulation.
近年来,深部脑刺激(DBS)在治疗多种神经系统疾病方面的应用不断扩展,如帕金森病、肌张力障碍、特发性震颤、图雷特综合征、丛集性头痛、癫痫、抑郁症和强迫症。DBS的目标结构包括边缘系统、联合区或运动区中非常小的亚核内特定的隔离区域。在本综述中,我们总结了当前DBS的临床技术、认知/情绪/运动结果,以及与特定脑靶点内功能区域相关的神经解剖学。新技术和技术的未来发展,可能包括更直接地可视化目标结构内的“运动”区域,这可能有助于避免因刺激联合区和边缘系统区域而产生的副作用。或者,更新的程序可能会选择并专门针对非运动区域进行慢性电刺激。