Kuhn J, Bodatsch M, Sturm V, Lenartz D, Klosterkötter J, Uhlhaas P J, Winter C, Gründler T O J
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität Köln, Köln.
Fortschr Neurol Psychiatr. 2011 Nov;79(11):632-41. doi: 10.1055/s-0031-1281733. Epub 2011 Nov 2.
Deep brain stimulation (DBS) has successfully advanced our treatment options for putative therapy-resistant neuropsychiatric diseases. Building on this strong foundation, more and more mental disorders in the stadium of therapy-resistance are considered as possible indications for DBS. Especially, schizophrenia with its associated severe and difficult to treat symptoms is gaining attention. This attention demands critical questions regarding the assumed mechanisms of DBS and its possible influence on the supposed pathophysiology of schizophrenia. Here, we synoptically compare current approaches and theories of DBS and discuss the feasibility of DBS in schizophrenia as well as the transferability from other psychiatric disorders successfully treated with DBS. For this we consider recent advances in animal models of schizophrenic symptoms, results regarding the influence of DBS on dopaminergic transmission as well as data concerning neural oscillation and synchronisation. In conclusion, the use of DBS for some symptoms of schizophrenia seems to be a promising approach, but the lack of a comprehensive theory of the mechanisms of DBS as well as its impact on schizophrenia might hinder the use of DBS for schizophrenia at this point in time.
深部脑刺激（DBS）已成功拓展了我们对难治性神经精神疾病的治疗选择。基于这一坚实基础，越来越多处于难治阶段的精神障碍被视为DBS的潜在适应证。尤其是精神分裂症及其相关的严重且难以治疗的症状正受到关注。这种关注引发了关于DBS假定机制及其对精神分裂症假定病理生理学可能影响的关键问题。在此，我们综合比较了当前DBS的方法和理论，并讨论了DBS在精神分裂症中的可行性以及从其他成功接受DBS治疗的精神障碍中的可转移性。为此，我们考虑了精神分裂症症状动物模型的最新进展、DBS对多巴胺能传递影响的结果以及有关神经振荡和同步化的数据。总之，将DBS用于治疗某些精神分裂症症状似乎是一种有前景的方法，但目前缺乏关于DBS机制及其对精神分裂症影响的全面理论，这可能会阻碍此时将DBS用于精神分裂症的治疗。
