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神经调节:深部脑刺激治疗肌张力障碍

Neuromodulation: Deep Brain Stimulation for Treatment of Dystonia.

作者信息

Dietz Nicholas, Neimat Joseph

机构信息

Department of Neurosurgery, University of Louisville, School of Medicine, 200 Abraham Flexner Highway, Louisville, KY 40202, USA.

Department of Neurosurgery, University of Louisville, School of Medicine, 200 Abraham Flexner Highway, Louisville, KY 40202, USA.

出版信息

Neurosurg Clin N Am. 2019 Apr;30(2):161-168. doi: 10.1016/j.nec.2018.12.001. Epub 2019 Feb 18.

Abstract

Dystonia is a heterogeneous, hyperkinetic movement disorder with sustained or intermittent abnormal postures, hyperkinetic muscle contractions, or repetitive movements. Classification of dystonia involves 2 axes: axis I and axis II, defining relevant clinical features and etiology, respectively. Medical therapy varies based on subtype and includes intramuscular botulinum toxin injections and oral anticholinergic pharmaceuticals. Deep brain stimulation became widely incorporated in 1999 after several landmark studies and has been effectively used in targets of the thalamus, pallidum, and subthalamic nucleus. New insights into pathophysiology of dystonia and genetic analysis continue to guide surgical technique toward ever-effective treatment.

摘要

肌张力障碍是一种异质性的运动亢进性疾病,表现为持续或间歇性的异常姿势、运动亢进性肌肉收缩或重复性动作。肌张力障碍的分类涉及两个轴:轴I和轴II,分别定义相关的临床特征和病因。药物治疗因亚型而异,包括肌肉注射肉毒杆菌毒素和口服抗胆碱能药物。经过多项具有里程碑意义的研究后,深部脑刺激在1999年得到广泛应用,并已有效地用于丘脑、苍白球和丘脑底核等靶点。对肌张力障碍病理生理学的新见解和基因分析继续指导手术技术朝着更有效的治疗方向发展。

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