Krook-Magnuson Esther, Gelinas Jennifer N, Soltesz Ivan, Buzsáki György
Department of Neuroscience, University of Minnesota, Minneapolis.
New York University Neuroscience Institute, Langone Medical Center, New York3New York University Center for Neural Sciences, New York.
JAMA Neurol. 2015 Jul;72(7):823-9. doi: 10.1001/jamaneurol.2015.0608.
Brain-implanted devices are no longer a futuristic idea. Traditionally, therapies for most neurological disorders are adjusted based on changes in clinical symptoms and diagnostic measures observed over time. These therapies are commonly pharmacological or surgical, requiring continuous or irreversible treatment regimens that cannot respond rapidly to fluctuations of symptoms or isolated episodes of dysfunction. In contrast, closed-loop systems provide intervention only when needed by detecting abnormal neurological signals and modulating them with instantaneous feedback. Closed-loop systems have been applied to several neurological conditions (most notably epilepsy and movement disorders), but widespread use is limited by conceptual and technical challenges. Herein, we discuss how advances in experimental closed-loop systems hold promise for improved clinical benefit in patients with neurological disorders.
植入大脑的设备已不再是未来才有的想法。传统上,大多数神经系统疾病的治疗是根据随着时间推移观察到的临床症状变化和诊断指标进行调整的。这些治疗通常是药物治疗或手术治疗,需要持续或不可逆的治疗方案,无法对症状波动或功能障碍的孤立发作迅速做出反应。相比之下,闭环系统通过检测异常神经信号并利用即时反馈对其进行调节,仅在需要时提供干预。闭环系统已应用于多种神经系统疾病(最显著的是癫痫和运动障碍),但由于概念和技术挑战,其广泛应用受到限制。在此,我们讨论实验性闭环系统的进展如何有望为神经系统疾病患者带来更大的临床益处。