深部脑刺激的历史、应用和机制。

History, applications, and mechanisms of deep brain stimulation.

机构信息

Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

出版信息

JAMA Neurol. 2013 Feb;70(2):163-71. doi: 10.1001/2013.jamaneurol.45.

Abstract

Deep brain stimulation (DBS) is an effective surgical treatment for medication-refractory hypokinetic and hyperkinetic movement disorders, and it is being explored for a variety of other neurological and psychiatric diseases. Deep brain stimulation has been Food and Drug Administration-approved for essential tremor and Parkinson disease and has a humanitarian device exemption for dystonia and obsessive-compulsive disorder. Neurostimulation is the fruit of decades of both technical and scientific advances in the field of basic neuroscience and functional neurosurgery. Despite the clinical success of DBS, the therapeutic mechanism of DBS remains under debate. Our objective is to provide a comprehensive review of DBS focusing on movement disorders, including the historical evolution of the technique, applications and outcomes with an overview of the most pertinent literature, current views on mechanisms of stimulation, and description of hardware and programming techniques. We conclude with a discussion of future developments in neurostimulation.

摘要

脑深部电刺激术(DBS)是一种治疗药物难治性运动障碍的有效手术方法,目前正在探索用于多种其他神经和精神疾病。脑深部电刺激术已获得美国食品和药物管理局(FDA)批准用于治疗原发性震颤和帕金森病,并因其对肌张力障碍和强迫症的治疗效果而获得人道主义设备豁免。神经刺激是基础神经科学和功能神经外科领域数十年来技术和科学进步的成果。尽管 DBS 取得了临床成功,但 DBS 的治疗机制仍存在争议。我们的目标是提供一个全面的脑深部电刺激术综述,重点关注运动障碍,包括该技术的历史演变、应用和结果,概述最相关的文献,当前对刺激机制的看法,以及硬件和编程技术的描述。最后,我们讨论了神经刺激的未来发展。

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