School of Psychology, Deakin University, Burwood, VIC, Australia.
Neurosci Biobehav Rev. 2012 Sep;36(8):1920-33. doi: 10.1016/j.neubiorev.2012.06.001. Epub 2012 Jun 18.
Deep brain stimulation (DBS), a neuromodulation therapy that has been used successfully in the treatment of symptoms associated with movement disorders, has recently undergone clinical trials for individuals suffering from treatment-resistant depression (TRD). Although the small patient numbers and open label study design limit our ability to identify optimum targets and make definitive conclusions about treatment efficacy, a review of the published research demonstrates significant reductions in depressive symptomatology and high rates of remission in a severely treatment-resistant patient group. Despite these encouraging results, an incomplete understanding of the mechanisms of action underlying the therapeutic effects of DBS for TRD is highlighted, paralleling the incomplete understanding of the neuroanatomy of mood regulation and treatment resistance. Proposed mechanisms of action include short and long-term local effects of stimulation at the neuronal level, to modulation of neural network activity.
脑深部电刺激（DBS）是一种神经调节疗法，已成功应用于治疗运动障碍相关症状。最近，DBS 也在接受临床试验，用于治疗治疗抵抗性抑郁症（TRD）患者。尽管患者数量少且采用开放标签设计限制了我们确定最佳靶点和对治疗效果得出明确结论的能力，但对已发表研究的回顾表明，严重 TRD 患者群体的抑郁症状显著减轻，缓解率高。尽管这些结果令人鼓舞，但 DBS 治疗 TRD 的治疗效果的作用机制仍不完全清楚，这与对情绪调节和治疗抵抗的神经解剖学的不完全了解相呼应。提出的作用机制包括刺激在神经元水平的短期和长期局部作用，以及对神经网络活动的调节。
