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刺激频率变化所揭示的运动障碍中深部脑刺激的机制

Mechanisms of deep brain stimulation in movement disorders as revealed by changes in stimulus frequency.

作者信息

Birdno Merrill J, Grill Warren M

机构信息

Department of Biomedical Engineering, Duke University, Durham, NC 27708-0281, USA.

出版信息

Neurotherapeutics. 2008 Jan;5(1):14-25. doi: 10.1016/j.nurt.2007.10.067.

Abstract

Deep brain stimulation (DBS) is an established treatment for symptoms in movement disorders and is under investigation for symptom management in persons with psychiatric disorders and epilepsy. Nevertheless, there remains disagreement regarding the physiological mechanisms responsible for the actions of DBS, and this lack of understanding impedes both the design of DBS systems for treating novel diseases and the effective tuning of current DBS systems. Currently available data indicate that effective DBS overrides pathological bursts, low frequency oscillations, synchronization, and disrupted firing patterns present in movement disorders, and replaces them with more regularized firing. Although it is likely that the specific mechanism(s) by which DBS exerts its effects varies between diseases and target nuclei, the overriding of pathological activity appears to be ubiquitous. This review provides an overview of changes in motor symptoms with changes in DBS frequency and highlights parallels between the changes in motor symptoms and the changes in cellular activity that appear to underlie the motor symptoms.

摘要

深部脑刺激(DBS)是治疗运动障碍症状的一种既定疗法,目前正在研究其对精神疾病和癫痫患者症状的管理作用。然而,对于DBS作用的生理机制仍存在分歧,这种认识上的不足既阻碍了用于治疗新疾病的DBS系统的设计,也妨碍了当前DBS系统的有效调整。现有数据表明,有效的DBS可抑制运动障碍中出现的病理性爆发、低频振荡、同步化和紊乱的放电模式,并用更规则的放电取而代之。尽管DBS发挥作用的具体机制可能因疾病和靶核而异,但抑制病理性活动似乎是普遍存在的。本综述概述了随着DBS频率变化运动症状的改变,并强调了运动症状变化与似乎构成运动症状基础的细胞活动变化之间的相似之处。

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