更改

Generally DBS is associated with 30–60% improvement in motor score evaluations.

Generally DBS is associated with 30–60% improvement in motor score evaluations.

一般来说，DBS 与运动成绩评定的30-60% 的改善有关。

一般来说，DBS 与运动成绩评定的30-60% 的改善有关<ref name="Dallapiazza2018" />。

=== Tourette syndrome ===

=== Tourette syndrome ===

{{further|Management of Tourette syndrome}}

{{further|Management of Tourette syndrome}}

DBS has been used experimentally in treating adults with severe [[Tourette syndrome]] who do not respond to conventional treatment. Despite widely publicized early successes, DBS remains a highly [[Biomedical research|experimental]] procedure for the treatment of Tourette's, and more study is needed to determine whether long-term benefits outweigh the risks.<ref name="Singer2011">{{cite book|vauthors = Singer HS|title = Hyperkinetic Movement Disorders|chapter = Tourette syndrome and other tic disorders|journal = Handbook of Clinical Neurology|volume = 100|pages = 641–57|date = March 2005|pmid = 21496613|doi = 10.1016/B978-0-444-52014-2.00046-X|isbn = 9780444520142}} Also see {{cite journal|vauthors = Singer HS|title = Tourette's syndrome: from behaviour to biology|journal = The Lancet. Neurology|volume = 4|issue = 3|pages = 149–59|date = March 2005|pmid = 15721825|doi = 10.1016/S1474-4422(05)01012-4|s2cid = 20181150}}</ref><ref name=Robertson2011>{{cite journal|vauthors = Robertson MM|title = Gilles de la Tourette syndrome: the complexities of phenotype and treatment|journal = British Journal of Hospital Medicine|volume = 72|issue = 2|pages = 100–07|date = February 2011|pmid = 21378617|doi = 10.12968/hmed.2011.72.2.100}}</ref><ref name=Du2010>{{cite journal|vauthors = Du JC, Chiu TF, Lee KM, Wu HL, Yang YC, Hsu SY, Sun CS, Hwang B, Leckman JF|title = Tourette syndrome in children: an updated review|journal = Pediatrics and Neonatology|volume = 51|issue = 5|pages = 255–64|date = October 2010|pmid = 20951354|doi = 10.1016/S1875-9572(10)60050-2|doi-access = free}}</ref><ref>[[Tourette Association of America|Tourette Syndrome Association]]. [https://web.archive.org/web/20051122154536/http://tsa-usa.org/news/DBS-Statement.htm Statement: Deep Brain Stimulation and Tourette Syndrome.] Retrieved November 22, 2005.</ref> The procedure is well tolerated, but complications include "short battery life, abrupt symptom worsening upon cessation of stimulation, hypomanic or manic conversion, and the significant time and effort involved in optimizing stimulation parameters".<ref name=Malone>{{cite journal|vauthors = Malone DA, Pandya MM|title = Behavioral neurosurgery|journal = Advances in Neurology|volume = 99|pages = 241–47|year = 2006|pmid = 16536372}}</ref> As of 2006, five people with TS had been reported on; all experienced reduction in tics and the disappearance of obsessive-compulsive behaviors.<ref name=Malone/>

DBS has been used experimentally in treating adults with severe [[Tourette syndrome]] who do not respond to conventional treatment. Despite widely publicized early successes, DBS remains a highly [[Biomedical research|experimental]] procedure for the treatment of Tourette's, and more study is needed to determine whether long-term benefits outweigh the risks.<ref name="Singer2011">{{cite book|vauthors = Singer HS|title = Hyperkinetic Movement Disorders|chapter = Tourette syndrome and other tic disorders|journal = Handbook of Clinical Neurology|volume = 100|pages = 641–57|date = March 2005|pmid = 21496613|doi = 10.1016/B978-0-444-52014-2.00046-X|isbn = 9780444520142}} Also see {{cite journal|vauthors = Singer HS|title = Tourette's syndrome: from behaviour to biology|journal = The Lancet. Neurology|volume = 4|issue = 3|pages = 149–59|date = March 2005|pmid = 15721825|doi = 10.1016/S1474-4422(05)01012-4|s2cid = 20181150}}</ref><ref name=Robertson2011>{{cite journal|vauthors = Robertson MM|title = Gilles de la Tourette syndrome: the complexities of phenotype and treatment|journal = British Journal of Hospital Medicine|volume = 72|issue = 2|pages = 100–07|date = February 2011|pmid = 21378617|doi = 10.12968/hmed.2011.72.2.100}}</ref><ref name=Du2010>{{cite journal|vauthors = Du JC, Chiu TF, Lee KM, Wu HL, Yang YC, Hsu SY, Sun CS, Hwang B, Leckman JF|title = Tourette syndrome in children: an updated review|journal = Pediatrics and Neonatology|volume = 51|issue = 5|pages = 255–64|date = October 2010|pmid = 20951354|doi = 10.1016/S1875-9572(10)60050-2|doi-access = free}}</ref><ref name=":5">[[Tourette Association of America|Tourette Syndrome Association]]. [https://web.archive.org/web/20051122154536/http://tsa-usa.org/news/DBS-Statement.htm Statement: Deep Brain Stimulation and Tourette Syndrome.] Retrieved November 22, 2005.</ref> The procedure is well tolerated, but complications include "short battery life, abrupt symptom worsening upon cessation of stimulation, hypomanic or manic conversion, and the significant time and effort involved in optimizing stimulation parameters".<ref name=Malone>{{cite journal|vauthors = Malone DA, Pandya MM|title = Behavioral neurosurgery|journal = Advances in Neurology|volume = 99|pages = 241–47|year = 2006|pmid = 16536372}}</ref> As of 2006, five people with TS had been reported on; all experienced reduction in tics and the disappearance of obsessive-compulsive behaviors.<ref name=Malone/>

DBS has been used experimentally in treating adults with severe Tourette syndrome who do not respond to conventional treatment. Despite widely publicized early successes, DBS remains a highly experimental procedure for the treatment of Tourette's, and more study is needed to determine whether long-term benefits outweigh the risks. Also see Tourette Syndrome Association. Statement: Deep Brain Stimulation and Tourette Syndrome. Retrieved November 22, 2005. The procedure is well tolerated, but complications include "short battery life, abrupt symptom worsening upon cessation of stimulation, hypomanic or manic conversion, and the significant time and effort involved in optimizing stimulation parameters". As of 2006, five people with TS had been reported on; all experienced reduction in tics and the disappearance of obsessive-compulsive behaviors.

DBS has been used experimentally in treating adults with severe Tourette syndrome who do not respond to conventional treatment. Despite widely publicized early successes, DBS remains a highly experimental procedure for the treatment of Tourette's, and more study is needed to determine whether long-term benefits outweigh the risks. Also see Tourette Syndrome Association. Statement: Deep Brain Stimulation and Tourette Syndrome. Retrieved November 22, 2005. The procedure is well tolerated, but complications include "short battery life, abrupt symptom worsening upon cessation of stimulation, hypomanic or manic conversion, and the significant time and effort involved in optimizing stimulation parameters". As of 2006, five people with TS had been reported on; all experienced reduction in tics and the disappearance of obsessive-compulsive behaviors.

DBS 已经用于治疗成人重度图雷特氏综合症，常规治疗无效。尽管早期的成功被广泛宣传，DBS 对于图雷特综合症的治疗仍然是一个高度实验性的过程，并且需要更多的研究来确定长期的好处是否大于风险。也可以参考美国图雷特氏综合症协会。声明: 深部脑部刺激和图雷特氏综合症。22,2005.该手术耐受性良好，但并发症包括”电池寿命短、刺激停止后突然症状恶化、狂躁或躁狂转换，以及优化刺激参数所需的大量时间和精力”。截至2006年，已有5人报告患有 TS，他们的抽搐症状都有所减轻，强迫行为也都消失了。

DBS已被实验性地用于治疗对常规治疗没有反应的成人严重'''图雷特综合征（ [[Tourette syndrome]]）'''。尽管早期的成功被广泛宣传，DBS治疗图雷特氏症仍然是一个高度'''实验性（[[Biomedical research|experimental]] ）'''的程序，需要更多的研究来确定长期的好处是否大于风险<ref name="Singer2011" /><ref name="Robertson2011" /><ref name="Du2010" /><ref name=":5" /> 。该手术耐受性良好，但并发症包括“电池寿命短，停止刺激后症状突然恶化，轻度躁狂或躁狂转化，以及优化刺激参数所需的大量时间和精力”<ref name="Malone" /> 。截至2006年，有5人被报告患有TS;所有人都经历了抽搐的减少和强迫行为的消失<ref name="Malone" />。

The procedure is invasive and expensive, and requires long-term expert care. Benefits for severe Tourette's are not conclusive, considering less robust effects of this surgery seen in the [[Netherlands]]. Tourette's is more common in [[pediatric]] populations, tending to remit in adulthood, so in general this would not be a recommended procedure for use on children. Because diagnosis of Tourette's is made based on a history of symptoms rather than analysis of neurological activity, it may not always be clear how to apply DBS for a particular person. Due to concern over the use of DBS in [[management of Tourette syndrome|Tourette syndrome treatment]], the [[Tourette Association of America]] convened a group of experts to develop recommendations guiding the use and potential [[clinical trials]] of DBS for TS.<ref>{{cite journal|vauthors = Mink JW, Walkup J, Frey KA, Como P, Cath D, Delong MR, Erenberg G, Jankovic J, Juncos J, Leckman JF, Swerdlow N, Visser-Vandewalle V, Vitek JL|title = Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome|journal = Movement Disorders|volume = 21|issue = 11|pages = 1831–38|date = November 2006|pmid = 16991144|doi = 10.1002/mds.21039|url = https://deepblue.lib.umich.edu/bitstream/2027.42/55891/1/21039_ftp.pdf|hdl = 2027.42/55891|s2cid = 16353255|hdl-access = free}}</ref>

The procedure is invasive and expensive, and requires long-term expert care. Benefits for severe Tourette's are not conclusive, considering less robust effects of this surgery seen in the [[Netherlands]]. Tourette's is more common in [[pediatric]] populations, tending to remit in adulthood, so in general this would not be a recommended procedure for use on children. Because diagnosis of Tourette's is made based on a history of symptoms rather than analysis of neurological activity, it may not always be clear how to apply DBS for a particular person. Due to concern over the use of DBS in [[management of Tourette syndrome|Tourette syndrome treatment]], the [[Tourette Association of America]] convened a group of experts to develop recommendations guiding the use and potential [[clinical trials]] of DBS for TS.<ref name=":6">{{cite journal|vauthors = Mink JW, Walkup J, Frey KA, Como P, Cath D, Delong MR, Erenberg G, Jankovic J, Juncos J, Leckman JF, Swerdlow N, Visser-Vandewalle V, Vitek JL|title = Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome|journal = Movement Disorders|volume = 21|issue = 11|pages = 1831–38|date = November 2006|pmid = 16991144|doi = 10.1002/mds.21039|url = https://deepblue.lib.umich.edu/bitstream/2027.42/55891/1/21039_ftp.pdf|hdl = 2027.42/55891|s2cid = 16353255|hdl-access = free}}</ref>

The procedure is invasive and expensive, and requires long-term expert care. Benefits for severe Tourette's are not conclusive, considering less robust effects of this surgery seen in the Netherlands. Tourette's is more common in pediatric populations, tending to remit in adulthood, so in general this would not be a recommended procedure for use on children. Because diagnosis of Tourette's is made based on a history of symptoms rather than analysis of neurological activity, it may not always be clear how to apply DBS for a particular person. Due to concern over the use of DBS in Tourette syndrome treatment, the Tourette Association of America convened a group of experts to develop recommendations guiding the use and potential clinical trials of DBS for TS.

The procedure is invasive and expensive, and requires long-term expert care. Benefits for severe Tourette's are not conclusive, considering less robust effects of this surgery seen in the Netherlands. Tourette's is more common in pediatric populations, tending to remit in adulthood, so in general this would not be a recommended procedure for use on children. Because diagnosis of Tourette's is made based on a history of symptoms rather than analysis of neurological activity, it may not always be clear how to apply DBS for a particular person. Due to concern over the use of DBS in Tourette syndrome treatment, the Tourette Association of America convened a group of experts to develop recommendations guiding the use and potential clinical trials of DBS for TS.

这种手术具有侵入性，费用昂贵，需要长期的专家护理。考虑到在荷兰进行的这种手术效果较差，重度抽动秽语综合症的益处还不能下结论。抽动秽语综合症在儿童群体中更为常见，成年后趋于缓解，所以一般不推荐在儿童身上使用这种疗法。因为妥瑞氏症的诊断是基于症状的历史而不是神经活动的分析，所以如何为特定的人应用 DBS 并不总是很清楚。出于对 DBS 用于图雷特氏综合症治疗的担忧，美国图雷特协会召集了一个专家小组，为 DBS 用于 TS 的使用和潜在的临床试验提出建议。

这种手术具有侵入性，费用昂贵，需要长期的专家护理。考虑到在'''荷兰（ [[Netherlands]]）'''进行的这种手术效果较差，重度抽动秽语综合症的益处还不能下结论。抽动秽语综合症在儿童群体中更为常见，成年后趋于缓解，所以一般不推荐在儿童身上使用这种疗法。因为抽动秽语综合症的诊断是基于症状的历史而不是神经活动的分析，所以如何为特定的人应用 DBS 并不总是很清楚。由于担心使用DBS'''治疗抽动秽语综合症（[[management of Tourette syndrome|Tourette syndrome treatment]]）'''，'''美国图雷特协会（ [[Tourette Association of America]]）'''召集了一组专家来制定建议，指导DBS治疗TS的使用和潜在的'''临床试验（[[clinical trials]]）'''<ref name=":6" />。

Robertson reported that DBS had been used on 55 adults by 2011, remained an experimental treatment at that time, and recommended that the procedure "should only be conducted by experienced functional neurosurgeons operating in centres which also have a dedicated Tourette syndrome clinic".<ref name=Robertson2011/> According to Malone ''et al.'' (2006), "Only patients with severe, debilitating, and treatment-refractory illness should be considered; while those with severe [[Personality disorder|personality disorders]] and substance-abuse problems should be excluded."<ref name=Malone/> Du ''et al.'' (2010) say, "As an invasive therapy, DBS is currently only advisable for severely affected, treatment-refractory TS adults".<ref name=Du2010/> Singer (2011) says, "pending determination of patient selection criteria and the outcome of carefully controlled clinical trials, a cautious approach is recommended".<ref name=Singer2011/> Viswanathan ''et al.'' (2012) say DBS should be used for people with "severe functional impairment that cannot be managed medically".<ref>{{cite journal|vauthors = Viswanathan A, Jimenez-Shahed J, Baizabal Carvallo JF, Jankovic J|title = Deep brain stimulation for Tourette syndrome: target selection|journal = Stereotactic and Functional Neurosurgery|volume = 90|issue = 4|pages = 213–24|year = 2012|pmid = 22699684|doi = 10.1159/000337776|doi-access = free}}</ref>

Robertson reported that DBS had been used on 55 adults by 2011, remained an experimental treatment at that time, and recommended that the procedure "should only be conducted by experienced functional neurosurgeons operating in centres which also have a dedicated Tourette syndrome clinic".<ref name=Robertson2011/> According to Malone ''et al.'' (2006), "Only patients with severe, debilitating, and treatment-refractory illness should be considered; while those with severe [[Personality disorder|personality disorders]] and substance-abuse problems should be excluded."<ref name=Malone/> Du ''et al.'' (2010) say, "As an invasive therapy, DBS is currently only advisable for severely affected, treatment-refractory TS adults".<ref name=Du2010/> Singer (2011) says, "pending determination of patient selection criteria and the outcome of carefully controlled clinical trials, a cautious approach is recommended".<ref name=Singer2011/> Viswanathan ''et al.'' (2012) say DBS should be used for people with "severe functional impairment that cannot be managed medically".<ref>{{cite journal|vauthors = Viswanathan A, Jimenez-Shahed J, Baizabal Carvallo JF, Jankovic J|title = Deep brain stimulation for Tourette syndrome: target selection|journal = Stereotactic and Functional Neurosurgery|volume = 90|issue = 4|pages = 213–24|year = 2012|pmid = 22699684|doi = 10.1159/000337776|doi-access = free}}</ref>

Robertson reported that DBS had been used on 55 adults by 2011, remained an experimental treatment at that time, and recommended that the procedure "should only be conducted by experienced functional neurosurgeons operating in centres which also have a dedicated Tourette syndrome clinic". According to Malone et al. (2006), "Only patients with severe, debilitating, and treatment-refractory illness should be considered; while those with severe personality disorders and substance-abuse problems should be excluded." Du et al. (2010) say, "As an invasive therapy, DBS is currently only advisable for severely affected, treatment-refractory TS adults". Singer (2011) says, "pending determination of patient selection criteria and the outcome of carefully controlled clinical trials, a cautious approach is recommended". Viswanathan et al. (2012) say DBS should be used for people with "severe functional impairment that cannot be managed medically".

Robertson reported that DBS had been used on 55 adults by 2011, remained an experimental treatment at that time, and recommended that the procedure "should only be conducted by experienced functional neurosurgeons operating in centres which also have a dedicated Tourette syndrome clinic". According to Malone et al. (2006), "Only patients with severe, debilitating, and treatment-refractory illness should be considered; while those with severe personality disorders and substance-abuse problems should be excluded." Du et al. (2010) say, "As an invasive therapy, DBS is currently only advisable for severely affected, treatment-refractory TS adults". Singer (2011) says, "pending determination of patient selection criteria and the outcome of carefully controlled clinical trials, a cautious approach is recommended". Viswanathan et al. (2012) say DBS should be used for people with "severe functional impairment that cannot be managed medically".

据 Robertson 报道，到2011年，DBS 已经在55名成年人身上使用，在当时仍然是一种试验性的治疗方法，并且建议这种手术“应该只由有经验的功能性神经外科医生进行，这些医生所在的中心还有一个专门的图雷特氏综合症诊所”。根据马龙等人的说法。(2006年) ，“只有患有严重的、使人衰弱的和治疗难以治愈的疾病的患者才应该被考虑; 而那些有严重的人格障碍和物质滥用问题的患者应该被排除在外。”杜等人。(2010)说，“作为一种侵入性治疗，DBS 目前仅适用于严重受影响、治疗难治性 TS 的成年人”。Singer (2011年)说，“在确定患者选择标准和仔细控制的临床试验结果之前，建议采取谨慎的方法”。维斯瓦纳森等人。(2012)表示，DBS 应该用于“严重功能障碍且无法医学治疗”的患者。

据 Robertson 报道，到2011年，DBS 已经在55名成年人身上使用，在当时仍然是一种试验性的治疗方法，并且建议这种手术“应该只由有经验的功能性神经外科医生进行，这些医生所在的中心还有一个专门的图雷特氏综合症诊所”<ref name="Robertson2011" /> 。根据Malone等人的说法(2006年) ，“只有患有严重的、使人衰弱的和治疗难以治愈的疾病的患者才应该被考虑; 而那些有严重的人格障碍和物质滥用问题的患者应该被排除在外“"<ref name="Malone" />。Du 等人(2010)说，“作为一种侵入性治疗，DBS 目前仅适用于严重受影响、治疗难治性 TS 的成年人”<ref name="Du2010" /> 。Singer (2011年)说，“在确定患者选择标准和仔细控制的临床试验结果之前，建议采取谨慎的方法”<ref name="Singer2011" />。Viswanathan等人(2012)表示，DBS 应该用于“严重功能障碍且无法医学治疗”的患者。

== Adverse effects ==

== Adverse effects ==