Sobstyl Michał, Dzierzecki Sebastian, Zabek Mirosław
Klinika Neurochirurgii CMKP, ul. Marymoncka 99, 01-813 Warszawa.
Neurol Neurochir Pol. 2009 Nov-Dec;43(6):559-69.
Despite significant advances in psychopharmacology, many patients with psychiatric disorders remain severely impaired by their conditions in their private, professional and social lives. Deep brain stimulation (DBS) is a proven method of surgical management of Parkinson's disease, dystonia and essential tremor. Electrodes implanted in deep brain structures have a direct neuromodulatory effect on neuronal structures responsible not only for movement disorders but also for psychiatric disorders. The stereotactic targets for psychiatric disorders include limbic parts of the nuclei of the limbic neuronal loop. At present, DBS is applied to treat medically refractory obsessive-compulsive disorder, depression and Tourette syndrome in small groups of patients. This overview includes the rationale for the use of DBS in psychiatric disorders, a summary of preliminary research done to date, and a discussion of achieved results.
尽管精神药理学取得了重大进展,但许多精神疾病患者在其私人、职业和社会生活中仍因病情而严重受损。深部脑刺激(DBS)是治疗帕金森病、肌张力障碍和特发性震颤的一种成熟的手术方法。植入深部脑结构的电极不仅对负责运动障碍的神经元结构,而且对精神疾病的神经元结构具有直接的神经调节作用。精神疾病的立体定向靶点包括边缘神经元回路核的边缘部分。目前,DBS已应用于一小部分患者,用于治疗药物难治性强迫症、抑郁症和图雷特综合征。本综述包括在精神疾病中使用DBS的理论依据、迄今为止所做初步研究的总结以及对已取得结果的讨论。