Halpern Casey H, Samadani Uzma, Litt Brian, Jaggi Jurg L, Baltuch Gordon H
Department of Neurosurgery, Center for Functional and Restorative Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA.
Neurotherapeutics. 2008 Jan;5(1):59-67. doi: 10.1016/j.nurt.2007.10.065.
Many patients who suffer from medically refractory epilepsy are not candidates for resective brain surgery. Success of deep brain stimulation (DBS) in relieving a significant number of symptoms of various movement disorders paved the way for investigations into this modality for epilepsy. Open-label and small blinded trials have provided promising evidence for the use of DBS in refractory seizures, and the first randomized control trial of DBS of the anterior thalamic nucleus is currently underway. There are multiple potential targets, because many neural regions have been implicated in seizure propagation. Thus, it is difficult as yet to make any definitive judgments about the efficacy of DBS for seizure control. Future study is necessary to identify a patient population for whom this technique would be indicated, the most efficacious target, and optimal stimulation parameters.
许多患有药物难治性癫痫的患者不适合进行脑切除手术。深部脑刺激(DBS)在缓解多种运动障碍的大量症状方面取得的成功为研究将这种方法用于癫痫治疗铺平了道路。开放标签试验和小型盲法试验为DBS用于难治性癫痫提供了有前景的证据,目前丘脑前核DBS的首个随机对照试验正在进行中。由于许多神经区域都与癫痫发作的传播有关,因此存在多个潜在靶点。因此,目前很难对DBS控制癫痫发作的疗效做出任何明确的判断。未来有必要开展研究,以确定适合采用这种技术的患者群体、最有效的靶点以及最佳刺激参数。