Reich M M, Kühn A A, Volkmann J
Neurologische Klinik und Poliklinik, Universitätsklinik Würzburg, Würzburg, Deutschland.
Nervenarzt. 2013 Aug;84(8):927-36. doi: 10.1007/s00115-013-3757-0.
Many patients with neurological movement disorders and psychiatric diseases cannot yet be adequately treated with conventional methods. Deep brain stimulation represents an important extension of therapeutic options by which invasive electrodes are implanted in various subcortical brain areas in order to achieve an improvement in motor and psychiatric symptoms by high frequency stimulation. Up to 2012 approximately 100,000 patients had been treated with deep brain stimulation worldwide. The indications for deep brain stimulation were essentially already established indications, such as idiopathic Parkinson's syndrome, dystonia and tremors. The newer indications which include in particular psychiatric symptoms, such as depression, obsessive diseases, addiction and Tourette syndrome, are as yet limited to approximately 5 % of treated patients. An increasingly better understanding of the system physiology of neurological and psychiatric diseases has promoted the search for new target areas and indications for treatment by neuromodulation. This article gives an overview of the latest developments in the established and also the developing application areas of deep brain stimulation.
许多患有神经运动障碍和精神疾病的患者目前仍无法通过传统方法得到充分治疗。深部脑刺激是治疗选择的一项重要扩展,通过将侵入性电极植入大脑各个皮质下区域,利用高频刺激来改善运动和精神症状。截至2012年,全球约有10万名患者接受了深部脑刺激治疗。深部脑刺激的适应症基本上都是已有的适应症,如特发性帕金森综合征、肌张力障碍和震颤。较新的适应症,特别是包括抑郁、强迫症、成瘾和图雷特综合征等精神症状,目前仅限于约5%的接受治疗的患者。对神经和精神疾病系统生理学的日益深入理解推动了对神经调节治疗新靶点和适应症的探索。本文概述了深部脑刺激既定应用领域以及发展中应用领域的最新进展。