Peeters Sophie, Skoch Jesse, Holt Hiromi, Mubita Lynn, Choudhary Eileen A, Vadivelu Kavan P, Gilbert Donald L, Wu Steve W, Keebaugh Alaine C, Air Ellen, Vadivelu Sudhakar
Division of Pediatric Neurosurgery and Neurology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Pediatr Neurosurg. 2018;53(2):71-80. doi: 10.1159/000485385. Epub 2018 Feb 3.
Secondary self-injurious behavior (SSIB) is underreported and predominantly not associated with suicide. In both adults and children, SSIB can cause intractable self-harm and is associated with a variety of clinical disorders, particularly those involving dysfunctional motor control.
We performed a literature review evaluating the clinical efficacy of deep-brain stimulation (DBS) as modulating SSIB observations and review current progress in preclinical SSIB animal studies.
Neuromodulation is an effective therapeutic option for several movement disorders. Interestingly, this approach is emerging as a potentially effective treatment for movement disorder-associated SSIB (secondary); however, it is important to understand the neuroanatomy, clinical appraisal, and outcome data when considering surgical therapy for SSIB.
The current review examines the literature encompassing animal models and human case studies while identifying existing hypotheses from cytoarchitectonic-based targeting to neurotransmitter-based pathways. This review also highlights the need for awareness of an underrecognized pathology that may be amenable to DBS.
继发性自伤行为（SSIB）的报告不足，且主要与自杀无关。在成人和儿童中，SSIB均可导致难以治愈的自我伤害，并与多种临床疾病相关，尤其是那些涉及运动控制功能障碍的疾病。
我们进行了一项文献综述，评估深部脑刺激（DBS）调节SSIB表现的临床疗效，并回顾临床前SSIB动物研究的当前进展。
神经调节是治疗多种运动障碍的有效选择。有趣的是，这种方法正逐渐成为治疗与运动障碍相关的SSIB（继发性）的潜在有效疗法；然而，在考虑对SSIB进行手术治疗时，了解神经解剖学、临床评估和结果数据非常重要。
本综述研究了涵盖动物模型和人类病例研究的文献，同时确定了从基于细胞结构的靶点到基于神经递质的通路的现有假设。本综述还强调了需要认识到一种可能适合DBS治疗的未被充分认识的病理情况。
