Umemura Atsushi
Juntendo Iji Zasshi. 2023 Feb 22;69(1):21-29. doi: 10.14789/jmj.JMJ22-0041-R. eCollection 2023.
There is a long history of surgical treatment for Parkinson's disease (PD). Currently, deep brain stimulation (DBS) has been performed as promising treatment option for medically refractory PD. DBS is an adjustable and reversible treatment using implanted medical devices to deliver electrical stimulation to precisely targeted areas of the brain. DBS modulates neurological function of the target region. The most common target for PD is the subthalamic nucleus (STN). DBS is particularly indicated for patients suffering from motor complications of dopaminergic medication such as fluctuations and dyskinesia. Although there is currently no curative treatment for PD, a combination of medical treatment and DBS provide long-term relief of motor symptoms. In this review, I introduce history, mechanism, indication, clinical outcome, complication, long term outcome, timing of surgery, surgical procedure, and current new technology concerning DBS for PD.
帕金森病(PD)的外科治疗有着悠久的历史。目前,深部脑刺激(DBS)已成为药物难治性PD的一种有前景的治疗选择。DBS是一种可调节且可逆的治疗方法,通过植入式医疗设备向大脑的精确靶点区域传递电刺激。DBS可调节目标区域的神经功能。PD最常见的靶点是丘脑底核(STN)。DBS特别适用于患有多巴胺能药物运动并发症(如波动和异动症)的患者。虽然目前尚无治愈PD的方法,但药物治疗和DBS相结合可长期缓解运动症状。在这篇综述中,我介绍了关于PD的DBS的历史、机制、适应症、临床结果、并发症、长期结果、手术时机、手术过程以及当前的新技术。