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深入探讨网络障碍性肌张力障碍的脑深部电刺激的电生理学见解。

Electrophysiological insights into deep brain stimulation of the network disorder dystonia.

机构信息

Oscar Langendorff Institute of Physiology, University Medical Center Rostock, Rostock, Germany.

Institute of Pharmacology, Pharmacy and Toxicology, University of Leipzig, Leipzig, Germany.

出版信息

Pflugers Arch. 2023 Oct;475(10):1133-1147. doi: 10.1007/s00424-023-02845-5. Epub 2023 Aug 2.

Abstract

Deep brain stimulation (DBS), a treatment for modulating the abnormal central neuronal circuitry, has become the standard of care nowadays and is sometimes the only option to reduce symptoms of movement disorders such as dystonia. However, on the one hand, there are still open questions regarding the pathomechanisms of dystonia and, on the other hand, the mechanisms of DBS on neuronal circuitry. That lack of knowledge limits the therapeutic effect and makes it hard to predict the outcome of DBS for individual dystonia patients. Finding electrophysiological biomarkers seems to be a promising option to enable adapted individualised DBS treatment. However, biomarker search studies cannot be conducted on patients on a large scale and experimental approaches with animal models of dystonia are needed. In this review, physiological findings of deep brain stimulation studies in humans and animal models of dystonia are summarised and the current pathophysiological concepts of dystonia are discussed.

摘要

深部脑刺激(DBS)是一种调节异常中枢神经元回路的治疗方法,现已成为当今的标准治疗方法,有时也是减轻运动障碍(如肌张力障碍)症状的唯一选择。然而,一方面,肌张力障碍的发病机制仍存在许多悬而未决的问题,另一方面,DBS 对神经元回路的作用机制也不明确。这些知识的缺乏限制了治疗效果,也使得难以预测个体化 DBS 治疗对每个肌张力障碍患者的效果。寻找电生理生物标志物似乎是一种很有前途的选择,可以实现个体化 DBS 治疗。但是,在患者中进行生物标志物搜索研究是不现实的,需要使用动物模型进行实验性研究。在这篇综述中,总结了人类深部脑刺激研究和动物模型的生理学发现,并讨论了目前关于肌张力障碍的病理生理学概念。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9806/10499667/7ab50b581313/424_2023_2845_Fig1_HTML.jpg

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