Ruan Hanyang, Tong Geya, Jin Minghui, Koch Kathrin, Wang Zhen
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Munich 81675, Germany.
Fundam Res. 2024 Jul 6;5(1):48-54. doi: 10.1016/j.fmre.2024.06.009. eCollection 2025 Jan.
Growing evidence supports the effectiveness of deep brain stimulation (DBS) in treating various psychiatric disorders. DBS has the potential to selectively stimulate specific subcortical brain areas thus providing high-frequency electric stimulation of these regions. The nucleus accumbens (NAc), a frequent DBS target, has shown promise in treating psychiatric conditions like depression, obsessive-compulsive disorder, and addiction. In this review, we provide an overview across studies investigating the effects of NAc DBS in humans and animals and discuss potential mechanisms underlying its clinical efficacy. We address the anatomical properties of NAc and discuss, in particular, the frequently reported differential effects of NAc shell and NAc core DBS. Moreover, by outlining the various NAc cell types, transmitter systems (i.e., predominantly GABAergic and dopaminergic systems) and anatomical pathways that have been shown to be relevant for NAc DBS stimulation effects, we aim to further elucidate the neurobiological determinants of NAc DBS efficacy. Finally, since treatment effects of NAc DBS are most probably also related to alterations in NAc connected circuits or networks, we review studies focusing on the investigation of NAc DBS network effects. By examining these various components that are assumed to be of relevance in the context of NAc DBS, this review will hopefully contribute to increasing our knowledge about the mechanisms underlying NAc DBS and optimizing future selection of optimal DBS targets.
越来越多的证据支持深部脑刺激（DBS）在治疗各种精神疾病方面的有效性。DBS有可能选择性地刺激特定的皮质下脑区，从而对这些区域提供高频电刺激。伏隔核（NAc）是DBS常用的靶点，在治疗抑郁症、强迫症和成瘾等精神疾病方面已显示出前景。在这篇综述中，我们概述了多项研究，这些研究调查了NAc DBS对人类和动物的影响，并讨论了其临床疗效背后的潜在机制。我们阐述了NAc的解剖学特性，并特别讨论了NAc壳核和NAc核心DBS经常报道的不同效果。此外，通过概述已被证明与NAc DBS刺激效果相关的各种NAc细胞类型、递质系统（即主要是GABA能和多巴胺能系统）和解剖学通路，我们旨在进一步阐明NAc DBS疗效的神经生物学决定因素。最后，由于NAc DBS的治疗效果很可能也与NAc连接回路或网络的改变有关，我们综述了聚焦于NAc DBS网络效应研究的相关研究。通过审视这些在NAc DBS背景下被认为相关的各种组成部分，本综述有望有助于增加我们对NAc DBS潜在机制的了解，并优化未来最佳DBS靶点的选择。
