Gubellini Paolo, Salin Pascal, Kerkerian-Le Goff Lydia, Baunez Christelle
Institut de Biologie du Développement de Marseille-Luminy (IBDML), UMR6216 CNRS/Université de la Méditerranée, Case 907, Parc Scientifique de Luminy, 13288 Marseille Cedex 9, France.
Prog Neurobiol. 2009 Sep;89(1):79-123. doi: 10.1016/j.pneurobio.2009.06.003. Epub 2009 Jun 25.
Deep brain stimulation (DBS) has proven to be capable of providing significant benefits for several neuropathologies. It is highly effective in reducing the motor symptoms of Parkinson's disease, essential tremor, and dystonia, and in alleviating chronic pain. Recently, also Tourette syndrome, obsessive-compulsive disorder and treatment-resistant depression have been treated by DBS with encouraging results. However, despite these clinical achievements, the precise action mechanisms of DBS still need to be fully characterized. For this reason, several animal models of DBS have been developed, bringing new insights on the effects of this treatment at molecular and cellular level, and providing new evidence on its physiological and behavioral consequences. In parallel, physiological and imaging studies in patients have contributed to better understanding DBS impact on the function of brain circuits. Here we review the clinical data and experimental work in vitro, ex vivo and in vivo (mostly arisen from studies on DBS of the subthalamic nucleus) in the treatment of PD, which led to the actual knowledge of DBS mechanisms, from molecular to complex behavioral levels.
深部脑刺激（DBS）已被证明能够为多种神经病理学疾病带来显著益处。它在减轻帕金森病、特发性震颤和肌张力障碍的运动症状以及缓解慢性疼痛方面非常有效。最近，DBS还被用于治疗抽动秽语综合征、强迫症和难治性抑郁症，并取得了令人鼓舞的结果。然而，尽管取得了这些临床成就，DBS的确切作用机制仍需全面阐明。因此，已经开发了几种DBS动物模型，为这种治疗在分子和细胞水平上的作用带来了新的见解，并为其生理和行为后果提供了新的证据。与此同时，对患者的生理和影像学研究有助于更好地理解DBS对脑回路功能的影响。在此，我们回顾了在治疗帕金森病时，体外、离体和体内（主要来自对丘脑底核DBS的研究）的临床数据和实验工作，这些工作使我们从分子水平到复杂行为水平，对DBS机制有了实际的认识。
