Park Hye Ran, Kim In Hyang, Kang Hyejin, Lee Dong Soo, Kim Bung-Nyun, Kim Dong Gyu, Paek Sun Ha
Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, South Korea.
Department of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.
Acta Neurochir (Wien). 2017 Jan;159(1):137-143. doi: 10.1007/s00701-016-3002-2. Epub 2016 Nov 3.
The aim of this report was to investigate the clinical outcome of deep brain stimulation (DBS) for autism spectrum disorder (ASD) and the functional and structural changes in the brain after DBS. We present a 14-year-old boy with ASD and self-injurious behavior (SIB) refractory with medical and behavioral therapy. He was treated by bilateral nucleus accumbens (NAc) DBS. Remarkable clinical improvement was observed following NAc DBS. Brain fluorodeoxyglucose-positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) volumetric studies revealed that the metabolism in the prefrontal and the frontal cortex as well as the occipital cortex was markedly decreased in association with the decreased cortical volumes in those areas 2 years after NAc DBS. The therapeutic potential of NAc DBS is suggested for the clinical improvement of patients with ASD and SIB with structural and functional changes after DBS.
本报告的目的是研究深部脑刺激（DBS）治疗自闭症谱系障碍（ASD）的临床疗效以及DBS后脑的功能和结构变化。我们报告一名14岁患有ASD且伴有自残行为（SIB）的男孩，其对药物和行为治疗均无效。他接受了双侧伏隔核（NAc）DBS治疗。NAc DBS治疗后观察到显著的临床改善。脑氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和磁共振成像（MRI）体积研究显示，NAc DBS治疗2年后，前额叶、额叶皮质以及枕叶皮质的代谢明显降低，且这些区域的皮质体积减小。NAc DBS的治疗潜力表明其可改善患有ASD和SIB的患者的临床症状，并在DBS后引起结构和功能变化。
