Okun Michael S, Oyama Genko
Center for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida.
Rinsho Shinkeigaku. 2013;53(9):691-4. doi: 10.5692/clinicalneurol.53.691.
Deep brain stimulation (DBS) has become an important treatment option for carefully screened medication resistant neurological and neuropsychiatric disorders. DBS therapy is not always applied deep to the brain; does not have to be applied exclusively to the brain; and the mechanism for DBS is not simply stimulation of structures. The applications and target locations for DBS devices are rapidly expanding, with many new regions of the brain, spinal cord, peripheral nerves, and muscles now possibly accessed through this technology. We will review the idea of "electrical neuro-network modulation (ENM)"; discuss the importance of the complex neural networks underpinning the effects of DBS; discuss the expansion of brain targets; discuss the use of fiber based targets; and discuss the importance of tailoring DBS therapy to the symptom, rather than the disease.
深部脑刺激（DBS）已成为经过精心筛选的药物难治性神经和神经精神疾病的重要治疗选择。DBS治疗并不总是应用于脑深部；不一定仅应用于脑部；而且DBS的机制不仅仅是对结构的刺激。DBS设备的应用和靶点位置正在迅速扩展，现在大脑、脊髓、周围神经和肌肉的许多新区域都有可能通过这项技术进行刺激。我们将回顾“电神经网络调制（ENM）”的概念；讨论支撑DBS效果的复杂神经网络的重要性；讨论脑靶点的扩展；讨论基于纤维的靶点的应用；并讨论根据症状而非疾病来定制DBS治疗的重要性。
