Krembil Research Institute University Health Network Toronto Western Hospital Toronto Ontario Canada.
Division of Neurology Toronto Western Hospital University of Toronto Toronto Ontario Canada.
Ann Clin Transl Neurol. 2018 Nov 8;6(1):174-185. doi: 10.1002/acn3.682. eCollection 2019 Jan.
Over the last two decades there has been an exponential rise in the number of patients receiving deep brain stimulation (DBS) to manage debilitating neurological symptoms in conditions such as Parkinson's disease, essential tremor, and dystonia. Novel applications of DBS continue to emerge including treatment of various psychiatric conditions (e.g. obsessive-compulsive disorder, major depression) and cognitive disorders such as Alzheimer's disease. Despite widening therapeutic applications, our understanding of the mechanisms underlying DBS remains limited. In addition to modulation of local and network-wide neuronal activity, growing evidence suggests that DBS may also have important neuroprotective effects in the brain by limiting synaptic dysfunction and neuronal loss in neurodegenerative disorders. In this review, we consider evidence from preclinical and clinical studies of DBS in Parkinson's disease, Alzheimer's disease, and epilepsy that suggest chronic stimulation has the potential to mitigate neuronal loss and disease progression.
在过去的二十年中，接受深部脑刺激（DBS）治疗的患者数量呈指数级增长，用于治疗帕金森病、特发性震颤和肌张力障碍等疾病的致残性神经症状。DBS 的新应用不断涌现，包括治疗各种精神疾病（如强迫症、重度抑郁症）和认知障碍，如阿尔茨海默病。尽管治疗应用范围不断扩大，但我们对 DBS 背后的机制的理解仍然有限。除了调节局部和全网络神经元活动外，越来越多的证据表明，DBS 还可能通过限制神经退行性疾病中的突触功能障碍和神经元丢失，对大脑具有重要的神经保护作用。在这篇综述中，我们考虑了来自帕金森病、阿尔茨海默病和癫痫的 DBS 的临床前和临床研究的证据，这些证据表明慢性刺激有可能减轻神经元丢失和疾病进展。
