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四种深部脑刺激治疗强迫症的靶点:它们有何不同?

Four Deep Brain Stimulation Targets for Obsessive-Compulsive Disorder: Are They Different?

机构信息

Department of Pharmacology and Physiology, University of Rochester School of Medicine and Dentistry, Rochester, New York; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Massachusetts.

Athinoula A. Martinos Center for Biomedical Imaging, Harvard University and Massachusetts General Hospital, Boston, Massachusetts.

出版信息

Biol Psychiatry. 2021 Nov 15;90(10):667-677. doi: 10.1016/j.biopsych.2020.06.031. Epub 2020 Jul 25.


DOI:10.1016/j.biopsych.2020.06.031
PMID:32951818
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9569132/
Abstract

Deep brain stimulation is a promising therapeutic approach for patients with treatment-resistant obsessive-compulsive disorder, a condition linked to abnormalities in corticobasal ganglia networks. Effective targets are placed in one of four subcortical areas with the goal of capturing prefrontal, anterior cingulate, and basal ganglia connections linked to the limbic system. These include the anterior limb of the internal capsule, the ventral striatum, the subthalamic nucleus, and a midbrain target. The goal of this review is to examine these 4 targets with respect to the similarities and differences of their connections. Following a review of the connections for each target based on anatomic studies in nonhuman primates, we examine the accuracy of diffusion magnetic resonance imaging tractography to replicate those connections in nonhuman primates, before evaluating the connections in the human brain based on diffusion magnetic resonance imaging tractography. Results demonstrate that the four targets generally involve similar connections, all of which are part of the internal capsule. Nonetheless, some connections are unique to each site. Delineating the similarities and differences across targets is a critical step for evaluating and comparing the effectiveness of each and how circuits contribute to the therapeutic outcome. It also underscores the importance that the terminology used for each target accurately reflects its position and its anatomic connections, so as to enable comparisons across clinical studies and for basic scientists to probe mechanisms underlying deep brain stimulation.

摘要

深部脑刺激是一种有前途的治疗方法,适用于治疗抵抗性强迫症患者,这种疾病与皮质基底节网络异常有关。有效的靶点被放置在四个皮质下区域之一,目的是捕捉与边缘系统有关的前额叶、前扣带和基底节连接。这些区域包括内囊前肢、腹侧纹状体、丘脑底核和中脑靶点。本综述的目的是检查这 4 个靶点,以了解它们连接的相似性和差异性。在对非人类灵长类动物的解剖研究进行了每个靶点的连接回顾之后,我们检查了扩散磁共振成像轨迹技术在非人类灵长类动物中复制这些连接的准确性,然后根据扩散磁共振成像轨迹技术评估人类大脑中的连接。结果表明,这四个靶点通常涉及相似的连接,所有这些连接都是内囊的一部分。尽管如此,一些连接是每个部位所特有的。跨靶点描绘相似性和差异性是评估和比较每个靶点的有效性以及回路如何有助于治疗结果的关键步骤。它还强调了用于每个靶点的术语准确反映其位置和解剖连接的重要性,以便能够在临床研究之间进行比较,并使基础科学家能够探究深部脑刺激的机制。

相似文献

[1]
Four Deep Brain Stimulation Targets for Obsessive-Compulsive Disorder: Are They Different?

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[10]
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引用本文的文献

[1]
Deep brain stimulation for obsessive-compulsive-disorder: a systematic review and meta-analysis of individual participant outcome data from sham-controlled trials.

Mol Psychiatry. 2025-6-27

[2]
Cross-species Standardised Cortico-Subcortical Tractography.

bioRxiv. 2025-6-11

[3]
Cross-species neuroanatomy in primates using tractography.

Brain Struct Funct. 2025-5-28

[4]
Mechanisms of DBS: from informational lesions to circuit modulation and implications in OCD.

Front Hum Neurosci. 2025-5-8

[5]
Challenges and opportunities of acquiring cortical recordings for chronic adaptive deep brain stimulation.

Nat Biomed Eng. 2025-5

[6]
Therapeutic DBS for OCD Suppresses the Default Mode Network.

Hum Brain Mapp. 2024-12-15

[7]
Joint Anatomical, Histological, and Imaging Investigation of the Midbrain Target Region for Superolateral Medial Forebrain Bundle Deep Brain Stimulation.

Stereotact Funct Neurosurg. 2025

[8]
Effective deep brain stimulation for obsessive-compulsive disorder after failed anterior capsulotomy: illustrative cases.

J Neurosurg Case Lessons. 2024-10-28

[9]
Cross-species striatal hubs: Linking anatomy to resting-state connectivity.

Neuroimage. 2024-11-1

[10]
Stereoelectroencephalography Electrode Implantation for Inpatient Workup of Treatment-Resistant Depression.

Neurosurgery. 2024-10-1

本文引用的文献

[1]
A unified connectomic target for deep brain stimulation in obsessive-compulsive disorder.

Nat Commun. 2020-7-3

[2]
Functional disruption in prefrontal-striatal network in obsessive-compulsive disorder.

Psychiatry Res Neuroimaging. 2020-4-22

[3]
Long versus short pulse width subcallosal cingulate stimulation for treatment-resistant depression: a randomised, double-blind, crossover trial.

Lancet Psychiatry. 2020-1

[4]
Holographic Reconstruction of Axonal Pathways in the Human Brain.

Neuron. 2019-11-7

[5]
Tractography-Guided Deep Brain Stimulation of the Anteromedial Globus Pallidus Internus for Refractory Obsessive-Compulsive Disorder: Case Report.

Neurosurgery. 2020-6-1

[6]
Deep brain stimulation of the internal capsule enhances human cognitive control and prefrontal cortex function.

Nat Commun. 2019-4-4

[7]
A Randomized Trial Directly Comparing Ventral Capsule and Anteromedial Subthalamic Nucleus Stimulation in Obsessive-Compulsive Disorder: Clinical and Imaging Evidence for Dissociable Effects.

Biol Psychiatry. 2019-1-30

[8]
Reduced focal fiber collinearity in the cingulum bundle in adults with obsessive-compulsive disorder.

Neuropsychopharmacology. 2019-2-25

[9]
Personalized striatal targets for deep brain stimulation in obsessive-compulsive disorder.

Brain Stimul. 2018-12-20

[10]
Individual white matter bundle trajectories are associated with deep brain stimulation response in obsessive-compulsive disorder.

Brain Stimul. 2018-11-27

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