Department of Neurology, The Walton Centre NHS Foundation Trust , Liverpool, UK.
School of Psychology, Faculty of Health and Life Sciences, University of Liverpool , Liverpool, UK.
Expert Rev Med Devices. 2020 Oct;17(10):1063-1074. doi: 10.1080/17434440.2020.1747433. Epub 2020 Apr 6.
Over the last three decades, extensive basic and clinical research has been performed on the use of subthalamic nucleus (STN) as the preferred deep brain stimulation (DBS) target for the treatment of Parkinson's disease (PD). The mechanism underlying the benefit for the motor symptoms in PD is related to the modulation of firing patterns within the hyperdirect projections from motor cortical areas, as well as within the afferent and efferent fibers to the motor STN. Advancements in neuroimaging techniques allow us to identify precisely the STN optimizing surgical targeting. In this review, we provide an update on the current uses of STN-DBS as a routine therapy as well as its experimental indications in PD, the critical aspects associated with its successful implementation and recent advances in DBS technology.
在过去的三十年中，人们对丘脑底核（STN）作为深部脑刺激（DBS）治疗帕金森病（PD）的首选靶点进行了广泛的基础和临床研究。PD 运动症状改善的机制与运动皮质区的直接投射内的放电模式的调节有关，也与传入和传出纤维到运动 STN 有关。神经影像学技术的进步使我们能够精确识别 STN，从而优化手术靶点。在这篇综述中，我们提供了 STN-DBS 的最新应用，包括作为常规治疗以及其在 PD 中的实验适应证，与成功实施相关的关键方面以及 DBS 技术的最新进展。
