Hu W, Klassen B T, Stead M
Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN, USA.
J Neurosurg Sci. 2011 Dec;55(4):305-17.
Over past three decades, there has been a resurgence of interest in functional neurosurgery for movement disorders. Recently, thanks to the increased understanding of cellular pathophysiology and advances in technology and surgical techniques, deep brain stimulation (DBS) has essentially replaced ablative procedures for most of these conditions. Success of DBS treatment in the movement disorders depends on the recognized limitations in the medical treatment, our understanding of the anatomy and physiology of these disorders and, particularly, involvement of neurologists, neurosurgeons, clinical neurophysiologists and neuropsychiatrists in outcome studies of DBS surgery. Up to now, the exact mechanism of DBS is not fully understood. This review provides an overview of use of stereotactic neurosurgery, particularly DBS, for movement disorders, focusing mainly on the patient selection, target options, clinical outcome, adverse effects and possible mechanisms of DBS for advanced Parkinson's disease, dystonia, and essential tremor.
在过去三十年里，人们对用于治疗运动障碍的功能神经外科的兴趣再度兴起。近来，由于对细胞病理生理学的认识不断加深以及技术和外科手术技巧的进步，深部脑刺激（DBS）在大多数此类病症中已基本取代了毁损性手术。DBS治疗运动障碍的成功取决于药物治疗中公认的局限性、我们对这些病症解剖学和生理学的理解，尤其是神经科医生、神经外科医生、临床神经生理学家和神经精神科医生参与DBS手术结果研究的情况。到目前为止，DBS的确切机制尚未完全明了。本综述概述了立体定向神经外科手术，特别是DBS用于治疗运动障碍的情况，主要聚焦于晚期帕金森病、肌张力障碍和特发性震颤的患者选择、靶点选择、临床结果、不良反应以及DBS的可能机制。
