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基底外侧杏仁核深部脑刺激术改善自闭症及相关自伤行为的症状:病例报告及对该疾病发病机制的假说。

DBS in the basolateral amygdala improves symptoms of autism and related self-injurious behavior: a case report and hypothesis on the pathogenesis of the disorder.

机构信息

Department of Stereotactic and Functional Neurosurgery, University of Cologne Cologne, Germany.

出版信息

Front Hum Neurosci. 2013 Jan 21;6:341. doi: 10.3389/fnhum.2012.00341. eCollection 2012.

Abstract

We treated a 13-year-old boy for life-threatening self-injurious behavior (SIB) and severe Kanner's autism with deep brain stimulation (DBS) in the amygdaloid complex as well as in the supra-amygdaloid projection system. Two DBS-electrodes were placed in both structures of each hemisphere. The stimulation contacts targeted the paralaminar, the basolateral (BL), the central amygdala as well as the supra-amygdaloid projection system. DBS was applied to each of these structures, but only stimulation of the BL part proved effective in improving SIB and core symptoms of the autism spectrum in the emotional, social, and even cognitive domains over a follow up of now 24 months. These results, which have been gained for the first time in a patient, support hypotheses, according to which the amygdala may be pivotal in the pathogeneses of autism and point to the special relevance of the BL part.

摘要

我们使用脑深部电刺激术(DBS)治疗了一名患有危及生命的自伤行为(SIB)和严重的坎纳氏自闭症的 13 岁男孩,刺激部位包括杏仁核复合体和上杏仁核投射系统。每个半球的两个 DBS 电极都被放置在这两个结构中。刺激触点针对的是旁室、基底外侧(BL)、杏仁核中央以及上杏仁核投射系统。对这些结构中的每一个都进行了刺激,但只有 BL 部分的刺激被证明在改善 SIB 和自闭症谱系的核心症状方面是有效的,这种改善在现在的 24 个月随访中得到了体现,在情感、社会甚至认知领域都有效果。这些在患者身上首次获得的结果支持了这样的假设,即杏仁核可能在自闭症的发病机制中起关键作用,并指出了 BL 部分的特殊重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaca/3549527/477500512306/fnhum-06-00341-g0001.jpg

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