Li Dong-Hong, Yang Xiao-Feng
Neuroelectrophysiological Laboratory, Xuanwu Hospital, Capital Medical University, Beijing, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
Neuroelectrophysiological Laboratory, Xuanwu Hospital, Capital Medical University, Beijing, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
Seizure. 2017 Apr;47:42-50. doi: 10.1016/j.seizure.2017.02.016. Epub 2017 Mar 4.
Deep brain stimulation (DBS) has become a well-accepted medical therapy in the treatment of movement disorders such as Parkinson's disease, and is currently under investigation as a treatment for other disorders, including epilepsy. Although DBS is widely used, its therapeutic mechanisms remain poorly understood. Recent research shows that seizures are network-level phenomena, but the incomplete knowledge of neural circuit function has left a gap in our understanding of how disruption at a molecular or cellular level generates epilepsy. In addition, DBS may potentially provide the opportunity to selectively modulate targeted brain regions and related networks. Therefore, a better understanding of the relationship between normal neural networks and epileptogenic networks, as well as the role of DBS in the modulation of neural networks will help us to find the optimal stimulation targets and parameters to achieve a better therapeutic effect. This review will outline the most recent advances in the relationship between normal brain networks and epileptogenic networks, and the modulation of DBS on the excitability of epileptogenic networks. We will then discuss how to optimize DBS stimulation targets and parameters by taking into consideration the concept of network modulation in order to improve treatment of epilepsy in the future.
深部脑刺激（DBS）已成为治疗帕金森病等运动障碍的一种广为接受的医学疗法，目前正在研究其作为包括癫痫在内的其他疾病的治疗方法。尽管DBS被广泛使用，但其治疗机制仍知之甚少。最近的研究表明，癫痫发作是网络层面的现象，但对神经回路功能的了解不完整，这使我们在理解分子或细胞水平的破坏如何引发癫痫方面存在差距。此外，DBS可能会提供选择性调节靶向脑区及相关网络的机会。因此，更好地理解正常神经网络与致痫网络之间的关系，以及DBS在神经网络调节中的作用，将有助于我们找到最佳刺激靶点和参数，以实现更好的治疗效果。本综述将概述正常脑网络与致痫网络之间关系的最新进展，以及DBS对致痫网络兴奋性的调节。然后，我们将讨论如何通过考虑网络调节的概念来优化DBS刺激靶点和参数，以便在未来改善癫痫治疗。
