Limousin Patricia, Martinez-Torres Irene
Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, England, United Kingdom.
Neurotherapeutics. 2008 Apr;5(2):309-19. doi: 10.1016/j.nurt.2008.01.006.
The surgical treatment of Parkinson's disease has been through a revival phase over the last 20 years with the development of deep brain stimulation (DBS). Thalamic DBS was developed first and has proven to be a very effective treatment for tremor. The limitation is the lack of effect on other symptoms. Other targets were therefore investigated, and the procedure was applied to the subthalamic nucleus (STN) and the internal globus pallidus (GPi). STN stimulation can improve a wide range of symptoms and is currently the preferred target for many patients. Nevertheless, the morbidity seems higher than with other targets, and the selection criteria have to be quite strict. When STN DBS is not advised, thalamic DBS remains an option for patients with severe tremor, and GPi stimulation for those with severe dyskinesias. DBS remains a symptomatic treatment for a limited number of patients; it does not seem to alter the disease progression, and many patients are not suitable. There is, therefore, the need for further research into other targets and other approaches.
在过去20年里，随着深部脑刺激（DBS）技术的发展，帕金森病的外科治疗进入了一个复兴阶段。丘脑DBS是最早开发的，已被证明是治疗震颤的一种非常有效的方法。其局限性在于对其他症状无效。因此，人们研究了其他靶点，并将该手术应用于丘脑底核（STN）和苍白球内侧部（GPi）。刺激STN可以改善多种症状，目前是许多患者的首选靶点。然而，其发病率似乎高于其他靶点，选择标准必须相当严格。当不建议进行STN DBS时，丘脑DBS仍然是严重震颤患者的一种选择，而GPi刺激则适用于严重运动障碍患者。DBS仍然是针对少数患者的对症治疗；它似乎不会改变疾病的进展，而且许多患者并不适合。因此，有必要进一步研究其他靶点和其他方法。
