Ko Andrew L, Burchiel Kim J
Prog Neurol Surg. 2018;33:94-106. doi: 10.1159/000480984. Epub 2018 Jan 12.
Deep brain stimulation (DBS) has become an established treatment for medically refractory movement disorders including Parkinson's disease, essential tremor, and dystonia. The field of DBS continues to evolve with advances in patient selection, target identification, electrode and pulse generator technology, and the development of more effective stimulation paradigms such as closed-loop stimulation. Furthermore, as the safety and efficacy of DBS improves through better hardware design and deeper understanding of its mechanisms of action, the indications for DBS will continue to expand to cover a wider range of disorders. Finally, the recent approval of MR-guided focused ultrasound for the treatment of essential tremor and potentially other movement disorders heralds a resurgence in lesion creation as a viable alternative to DBS for selected patients.
深部脑刺激(DBS)已成为治疗包括帕金森病、特发性震颤和肌张力障碍在内的药物难治性运动障碍的既定疗法。随着患者选择、靶点识别、电极和脉冲发生器技术的进步,以及诸如闭环刺激等更有效刺激模式的发展,DBS领域不断发展。此外,随着通过更好的硬件设计和对其作用机制的更深入理解,DBS的安全性和有效性得到提高,DBS的适应症将继续扩大,以涵盖更广泛的疾病。最后,最近磁共振引导聚焦超声治疗特发性震颤及可能的其他运动障碍的获批,预示着作为DBS的一种可行替代方案,毁损术将重新兴起,适用于特定患者。