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无编辑摘要
1997年，DBS 已经被'''美国食品和药物管理局([[Food and Drug Administration]])'''批准用于治疗原发性震颤和'''帕金森病([[Parkinson's disease]])'''<ref name=":0" />。2003年被批准,以“脑起搏器”的方法用于'''肌张力障碍([[dystonia]])'''<ref name=":1" /> ，2009年被批准用于强迫症，2018年用于癫痫<ref name=":2" /><ref name=":3" /><ref name="gildenberg" />。DBS 已经在临床试验中被研究用作各种情感障碍(包括'''重度抑郁症([[major depressive disorder|major depression]])''')的'''慢性疼痛([[chronic pain]])'''的潜在治疗方法。这是少数允许'''盲法研究( [[Blind experiment|blinded studies]])'''的神经外科手术之一<ref name="Kringelbach" />。
1997年，DBS 已经被'''美国食品和药物管理局([[Food and Drug Administration]])'''批准用于治疗原发性震颤和'''帕金森病([[Parkinson's disease]])'''<ref name=":0" />。2003年被批准,以“脑起搏器”的方法用于'''肌张力障碍([[dystonia]])'''<ref name=":1" /> ，2009年被批准用于强迫症，2018年用于癫痫<ref name=":2" /><ref name=":3" /><ref name="gildenberg" />。DBS 已经在临床试验中被研究用作各种情感障碍(包括'''重度抑郁症([[major depressive disorder|major depression]])''')的'''慢性疼痛([[chronic pain]])'''的潜在治疗方法。这是少数允许'''盲法研究( [[Blind experiment|blinded studies]])'''的神经外科手术之一<ref name="Kringelbach" />。
== Medical use ==
== Medical use（医疗用途） ==
[[Image:Parkinson surgery.jpg|thumb|250px|Insertion of electrode during surgery using a [[Stereotactic surgery|stereotactic frame]]|链接=Special:FilePath/Parkinson_surgery.jpg]]
[[Image:Parkinson surgery.jpg|thumb|250px|Insertion of electrode during surgery using a [[Stereotactic surgery|stereotactic frame]]|链接=Special:FilePath/Parkinson_surgery.jpg]]
=== Parkinson's disease ===
=== Parkinson's disease（帕金森氏病） ===
DBS is used to manage some of the symptoms of Parkinson's disease that cannot be adequately controlled with medications.<ref name=NINDS/><ref name="USDHHS">U.S. Department of Health and Human Services. [https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm083894.htm FDA approves implanted brain stimulator to control tremors.] Retrieved February 10, 2015.</ref> PD is treated by applying high-frequency (> 100 Hz) stimulation to three target structures namely to entrolateral thalamus, internal pallidum, and subthalamic nucleus (STN) to mimic the clinical effects of lesioning.<ref name=":4">Koller, W. and Melamed, E., 2007. Parkinson's disease and related disorders. 1st ed. Edinburgh: Elsevier.</ref> It is recommended for people who have PD with motor fluctuations and tremor inadequately controlled by medication, or to those who are intolerant to medication, as long as they do not have severe [[wikt:neuropsychiatric|neuropsychiatric]] problems.<ref name="pmid20937936">{{cite journal |vauthors=Bronstein JM, Tagliati M, Alterman RL, Lozano AM, Volkmann J, Stefani A, Horak FB, Okun MS, Foote KD, Krack P, Pahwa R, Henderson JM, Hariz MI, Bakay RA, Rezai A, Marks WJ, Moro E, Vitek JL, Weaver FM, Gross RE, DeLong MR |title=Deep brain stimulation for Parkinson disease: an expert consensus and review of key issues |journal=Archives of Neurology |volume=68 |issue=2 |page=165 |date=February 2011 |pmid=20937936 |pmc=4523130 |doi=10.1001/archneurol.2010.260 |display-authors=1}}</ref> Four areas of the brain have been treated with neural stimulators in PD. These are the [[globus pallidus internus]], [[thalamus]], [[subthalamic nucleus]] and the [[pedunculopontine nucleus]]. However, most DBS surgeries in routine practice target either the globus pallidus internus, or the Subthalamic nucleus.
DBS is used to manage some of the symptoms of Parkinson's disease that cannot be adequately controlled with medications.<ref name=NINDS/><ref name="USDHHS">U.S. Department of Health and Human Services. [https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm083894.htm FDA approves implanted brain stimulator to control tremors.] Retrieved February 10, 2015.</ref> PD is treated by applying high-frequency (> 100 Hz) stimulation to three target structures namely to entrolateral thalamus, internal pallidum, and subthalamic nucleus (STN) to mimic the clinical effects of lesioning.<ref name=":4">Koller, W. and Melamed, E., 2007. Parkinson's disease and related disorders. 1st ed. Edinburgh: Elsevier.</ref> It is recommended for people who have PD with motor fluctuations and tremor inadequately controlled by medication, or to those who are intolerant to medication, as long as they do not have severe [[wikt:neuropsychiatric|neuropsychiatric]] problems.<ref name="pmid20937936">{{cite journal |vauthors=Bronstein JM, Tagliati M, Alterman RL, Lozano AM, Volkmann J, Stefani A, Horak FB, Okun MS, Foote KD, Krack P, Pahwa R, Henderson JM, Hariz MI, Bakay RA, Rezai A, Marks WJ, Moro E, Vitek JL, Weaver FM, Gross RE, DeLong MR |title=Deep brain stimulation for Parkinson disease: an expert consensus and review of key issues |journal=Archives of Neurology |volume=68 |issue=2 |page=165 |date=February 2011 |pmid=20937936 |pmc=4523130 |doi=10.1001/archneurol.2010.260 |display-authors=1}}</ref> Four areas of the brain have been treated with neural stimulators in PD. These are the [[globus pallidus internus]], [[thalamus]], [[subthalamic nucleus]] and the [[pedunculopontine nucleus]]. However, most DBS surgeries in routine practice target either the globus pallidus internus, or the Subthalamic nucleus.
* DBS of the globus pallidus internus reduces uncontrollable shaking movements called [[dyskinesia]]s. This enables a patient to take adequate quantities of medications (especially levodopa), thus leading to better control of symptoms.
* DBS of the globus pallidus internus reduces uncontrollable shaking movements called [[dyskinesia]]s. This enables a patient to take adequate quantities of medications (especially levodopa), thus leading to better control of symptoms.
一般来说，DBS 与运动成绩评定的30-60% 的改善有关<ref name="Dallapiazza2018" />。
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（妥瑞症） ===
{{further|Management of Tourette syndrome}}
{{further|Management of Tourette syndrome}}
Robertson 报告说，截至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。
Robertson 报告说，截至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（不良反应） ==
[[File:Mra1.jpg|thumb|left|Arteriogram of the arterial supply that can hemorrhage during DBS implantation.|链接=Special:FilePath/Mra1.jpg]]
[[File:Mra1.jpg|thumb|left|Arteriogram of the arterial supply that can hemorrhage during DBS implantation.|链接=Special:FilePath/Mra1.jpg]]
游泳技能受损被认为是该手术的一个意外风险;几名帕金森氏症患者在接受脑深部刺激后失去了游泳能力<ref name=":10" /><ref name=":11" />。
游泳技能受损被认为是该手术的一个意外风险;几名帕金森氏症患者在接受脑深部刺激后失去了游泳能力<ref name=":10" /><ref name=":11" />。
== Mechanisms ==
== Mechanisms（机制） ==
The exact mechanism of action of DBS is not known.<ref name=":12">{{cite book |author1=Mogilner A.Y. |author2=Benabid A.L. |author3=Rezai A.R. |chapter=Chronic Therapeutic Brain Stimulation: History, Current Clinical Indications, and Future Prospects |editor1=Markov, Marko |editor2=Paul J. Rosch |title=Bioelectromagnetic medicine |publisher=Marcel Dekker |location=New York |year=2004 |pages=133–51 |isbn=978-0-8247-4700-8}}</ref> A variety of hypotheses try to explain the mechanisms of DBS:<ref name=":13">{{cite journal|vauthors = McIntyre CC, Thakor NV|title = Uncovering the mechanisms of deep brain stimulation for Parkinson's disease through functional imaging, neural recording, and neural modeling|journal = Critical Reviews in Biomedical Engineering|volume = 30|issue = 4–6|pages = 249–81|year = 2002|pmid = 12739751|doi = 10.1615/critrevbiomedeng.v30.i456.20}}</ref><ref name=":14">{{cite journal|vauthors = Herrington TM, Cheng JJ, Eskandar EN|title = Mechanisms of deep brain stimulation|journal = Journal of Neurophysiology|volume = 115|issue = 1|pages = 19–38|date = January 2016|pmid = 26510756|pmc = 4760496|doi = 10.1152/jn.00281.2015}}</ref>
The exact mechanism of action of DBS is not known.<ref name=":12">{{cite book |author1=Mogilner A.Y. |author2=Benabid A.L. |author3=Rezai A.R. |chapter=Chronic Therapeutic Brain Stimulation: History, Current Clinical Indications, and Future Prospects |editor1=Markov, Marko |editor2=Paul J. Rosch |title=Bioelectromagnetic medicine |publisher=Marcel Dekker |location=New York |year=2004 |pages=133–51 |isbn=978-0-8247-4700-8}}</ref> A variety of hypotheses try to explain the mechanisms of DBS:<ref name=":13">{{cite journal|vauthors = McIntyre CC, Thakor NV|title = Uncovering the mechanisms of deep brain stimulation for Parkinson's disease through functional imaging, neural recording, and neural modeling|journal = Critical Reviews in Biomedical Engineering|volume = 30|issue = 4–6|pages = 249–81|year = 2002|pmid = 12739751|doi = 10.1615/critrevbiomedeng.v30.i456.20}}</ref><ref name=":14">{{cite journal|vauthors = Herrington TM, Cheng JJ, Eskandar EN|title = Mechanisms of deep brain stimulation|journal = Journal of Neurophysiology|volume = 115|issue = 1|pages = 19–38|date = January 2016|pmid = 26510756|pmc = 4760496|doi = 10.1152/jn.00281.2015}}</ref>
它对脑细胞和'''神经递质（[[neurotransmitters]]）'''的直接影响目前还在争论中，但通过向大脑的特定区域发送高频电脉冲，它可以s减轻症状<ref name=":16" /> ，直接减少帕金森病药物引起的副作用<ref name=":17" />，使药物减少，或使药物治疗方案更容易忍受{{citation needed|date=January 2017}}。
它对脑细胞和'''神经递质（[[neurotransmitters]]）'''的直接影响目前还在争论中，但通过向大脑的特定区域发送高频电脉冲，它可以s减轻症状<ref name=":16" /> ，直接减少帕金森病药物引起的副作用<ref name=":17" />，使药物减少，或使药物治疗方案更容易忍受{{citation needed|date=January 2017}}。
== Components and placement ==
== Components and placement（组成和布局） ==
The DBS system consists of three components: the implanted pulse generator (IPG), the lead, and an extension. The IPG is a [[battery (electricity)|battery]]-powered neurostimulator encased in a [[titanium]] housing, which sends electrical pulses to the brain that interfere with [[neural]] [[action potential|activity]] at the target site. The lead is a coiled wire insulated in [[polyurethane]] with four [[platinum-iridium alloy|platinum-iridium]] electrodes and is placed in one or two different nuclei of the brain. The lead is connected to the IPG by an extension, an insulated wire that runs below the skin, from the head, down the side of the neck, behind the ear, to the IPG, which is placed subcutaneously below the [[clavicle]], or in some cases, the [[Human abdomen|abdomen]].<ref name=NINDS>[[National Institute of Neurological Disorders and Stroke]]. [http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm Deep brain stimulation for Parkinson's disease information page] {{Webarchive|url=https://web.archive.org/web/20161120064914/http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm |date=2016-11-20}} Retrieved November 23, 2006.</ref> The IPG can be calibrated by a [[neurology|neurologist]], [[nurse]], or trained [[technician]] to optimize symptom suppression and control side effects.<ref name=Volkmann>{{cite journal|vauthors = Volkmann J, Herzog J, Kopper F, Deuschl G|title = Introduction to the programming of deep brain stimulators|journal = Movement Disorders|volume = 17 Suppl 3|pages = S181–87|year = 2002|pmid = 11948775|doi = 10.1002/mds.10162|s2cid = 21988668}}</ref>
The DBS system consists of three components: the implanted pulse generator (IPG), the lead, and an extension. The IPG is a [[battery (electricity)|battery]]-powered neurostimulator encased in a [[titanium]] housing, which sends electrical pulses to the brain that interfere with [[neural]] [[action potential|activity]] at the target site. The lead is a coiled wire insulated in [[polyurethane]] with four [[platinum-iridium alloy|platinum-iridium]] electrodes and is placed in one or two different nuclei of the brain. The lead is connected to the IPG by an extension, an insulated wire that runs below the skin, from the head, down the side of the neck, behind the ear, to the IPG, which is placed subcutaneously below the [[clavicle]], or in some cases, the [[Human abdomen|abdomen]].<ref name=NINDS>[[National Institute of Neurological Disorders and Stroke]]. [http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm Deep brain stimulation for Parkinson's disease information page] {{Webarchive|url=https://web.archive.org/web/20161120064914/http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm |date=2016-11-20}} Retrieved November 23, 2006.</ref> The IPG can be calibrated by a [[neurology|neurologist]], [[nurse]], or trained [[technician]] to optimize symptom suppression and control side effects.<ref name=Volkmann>{{cite journal|vauthors = Volkmann J, Herzog J, Kopper F, Deuschl G|title = Introduction to the programming of deep brain stimulators|journal = Movement Disorders|volume = 17 Suppl 3|pages = S181–87|year = 2002|pmid = 11948775|doi = 10.1002/mds.10162|s2cid = 21988668}}</ref>
这三种成分都要通过手术植入体内。铅植入可在局部麻醉或全身麻醉下进行(“睡眠DBS”)，如肌张力障碍。在颅骨上钻一个直径约14毫米的孔，使用基于框架或无框架的'''立体定向（[[Stereotactic surgery|stereotactically]]）'''方式将探针电极立体定向插入<ref name=":20" />。在局部麻醉的清醒过程中，来自人的反馈被用来确定永久电极的最佳放置位置。在睡眠过程中，利用术中MRI引导对脑组织和设备进行直接可视化<ref name=":21" /> 。IPG和延伸导线的安装是在全身麻醉下进行的<ref name=":22" />。刺激右脑来解决身体左侧的症状，反之亦然{{citation needed|date=January 2017}}。
这三种成分都要通过手术植入体内。铅植入可在局部麻醉或全身麻醉下进行(“睡眠DBS”)，如肌张力障碍。在颅骨上钻一个直径约14毫米的孔，使用基于框架或无框架的'''立体定向（[[Stereotactic surgery|stereotactically]]）'''方式将探针电极立体定向插入<ref name=":20" />。在局部麻醉的清醒过程中，来自人的反馈被用来确定永久电极的最佳放置位置。在睡眠过程中，利用术中MRI引导对脑组织和设备进行直接可视化<ref name=":21" /> 。IPG和延伸导线的安装是在全身麻醉下进行的<ref name=":22" />。刺激右脑来解决身体左侧的症状，反之亦然{{citation needed|date=January 2017}}。
== Research ==
== Research（研究） ==
=== Chronic pain ===
=== Chronic pain（慢性痛） ===
Stimulation of the [[periaqueductal gray]] and [[Periventricular nucleus|periventricular gray]] for [[Pain#Nociceptive|nociceptive pain]], and the [[internal capsule]], [[ventral posterolateral nucleus]], and [[ventral posteromedial nucleus]] for [[Pain#Nociceptive|neuropathic pain]] has produced impressive results with some people, but results vary. One study<ref name = Young>{{cite journal|authors = Young RF & Brechner T|title = Electrical stimulation of the brain for relief of intractable pain due to cancer|journal = Cancer|volume = 57|year = 1986|issue = 6|pages = 1266–72|pmid = 3484665|doi=10.1002/1097-0142(19860315)57:6<1266::aid-cncr2820570634>3.0.co;2-q| doi-access = free}}</ref> of 17 people with intractable cancer pain found that 13 were virtually pain free and only four required opioid analgesics on release from hospital after the intervention. Most ultimately did resort to opioids, usually in the last few weeks of life.<ref name="Johnson">{{cite book|authors = Johnson MI, Oxberry SG & Robb K|chapter = Stimulation-induced analgesia|pages = 235–50|editor = Sykes N, Bennett MI & Yuan C-S|title = Clinical pain management: Cancer pain|edition = 2nd|isbn = 978-0-340-94007-5|publisher = Hodder Arnold|location = London|year = 2008}}</ref> DBS has also been applied for [[phantom limb pain]].<ref name=":23">{{cite journal|vauthors = Kringelbach ML, Jenkinson N, Green AL, Owen SL, Hansen PC, Cornelissen PL, Holliday IE, Stein J, Aziz TZ|title = Deep brain stimulation for chronic pain investigated with magnetoencephalography|journal = NeuroReport|volume = 18|issue = 3|pages = 223–28|date = February 2007|pmid = 17314661|doi = 10.1097/wnr.0b013e328010dc3d|citeseerx = 10.1.1.511.2667|s2cid = 7091307}}</ref>
Stimulation of the [[periaqueductal gray]] and [[Periventricular nucleus|periventricular gray]] for [[Pain#Nociceptive|nociceptive pain]], and the [[internal capsule]], [[ventral posterolateral nucleus]], and [[ventral posteromedial nucleus]] for [[Pain#Nociceptive|neuropathic pain]] has produced impressive results with some people, but results vary. One study<ref name = Young>{{cite journal|authors = Young RF & Brechner T|title = Electrical stimulation of the brain for relief of intractable pain due to cancer|journal = Cancer|volume = 57|year = 1986|issue = 6|pages = 1266–72|pmid = 3484665|doi=10.1002/1097-0142(19860315)57:6<1266::aid-cncr2820570634>3.0.co;2-q| doi-access = free}}</ref> of 17 people with intractable cancer pain found that 13 were virtually pain free and only four required opioid analgesics on release from hospital after the intervention. Most ultimately did resort to opioids, usually in the last few weeks of life.<ref name="Johnson">{{cite book|authors = Johnson MI, Oxberry SG & Robb K|chapter = Stimulation-induced analgesia|pages = 235–50|editor = Sykes N, Bennett MI & Yuan C-S|title = Clinical pain management: Cancer pain|edition = 2nd|isbn = 978-0-340-94007-5|publisher = Hodder Arnold|location = London|year = 2008}}</ref> DBS has also been applied for [[phantom limb pain]].<ref name=":23">{{cite journal|vauthors = Kringelbach ML, Jenkinson N, Green AL, Owen SL, Hansen PC, Cornelissen PL, Holliday IE, Stein J, Aziz TZ|title = Deep brain stimulation for chronic pain investigated with magnetoencephalography|journal = NeuroReport|volume = 18|issue = 3|pages = 223–28|date = February 2007|pmid = 17314661|doi = 10.1097/wnr.0b013e328010dc3d|citeseerx = 10.1.1.511.2667|s2cid = 7091307}}</ref>
刺激'''导水管周围灰质（ [[periaqueductal gray]]）'''和'''脑室周围灰质（ [[Periventricular nucleus|periventricular gray]] ）'''来治疗'''痛觉性疼痛（[[Pain#Nociceptive|nociceptive pain]]）'''，刺激'''内囊（ [[internal capsule]]）'''、'''腹侧后外侧核（ [[ventral posterolateral nucleus]]）'''和'''腹侧后内侧核（[[ventral posteromedial nucleus]]）'''来治疗'''神经性疼痛（[[Pain#Nociceptive|neuropathic pain]]）'''，对一些人产生了令人印象深刻的结果，但结果各不相同。一项<ref name="Young" /> 针对17名癌症顽固性疼痛患者的研究发现，其中13人几乎没有疼痛，只有4人在干预后出院时需要服用阿片类镇痛药。大多数人最终诉诸于阿片类药物，通常是在生命的最后几周<ref name="Johnson" /> 。DBS也被用于治疗'''幻肢疼痛（[[phantom limb pain]]）'''<ref name=":23" />。
刺激'''导水管周围灰质（ [[periaqueductal gray]]）'''和'''脑室周围灰质（ [[Periventricular nucleus|periventricular gray]] ）'''来治疗'''痛觉性疼痛（[[Pain#Nociceptive|nociceptive pain]]）'''，刺激'''内囊（ [[internal capsule]]）'''、'''腹侧后外侧核（ [[ventral posterolateral nucleus]]）'''和'''腹侧后内侧核（[[ventral posteromedial nucleus]]）'''来治疗'''神经性疼痛（[[Pain#Nociceptive|neuropathic pain]]）'''，对一些人产生了令人印象深刻的结果，但结果各不相同。一项<ref name="Young" /> 针对17名癌症顽固性疼痛患者的研究发现，其中13人几乎没有疼痛，只有4人在干预后出院时需要服用阿片类镇痛药。大多数人最终诉诸于阿片类药物，通常是在生命的最后几周<ref name="Johnson" /> 。DBS也被用于治疗'''幻肢疼痛（[[phantom limb pain]]）'''<ref name=":23" />。
=== Major depression and obsessive-compulsive disorder ===
=== Major depression and obsessive-compulsive disorder(重度抑郁症和强迫症) ===
[[File:X-ray of deep brain stimulation in OCD, L.png|thumb|Lateral X-ray of the head: Deep brain stimulation in [[Obsessive–compulsive disorder]] (OCD). 42 year old man, surgery in 2013.|链接=Special:FilePath/X-ray_of_deep_brain_stimulation_in_OCD,_L.png]]
[[File:X-ray of deep brain stimulation in OCD, L.png|thumb|Lateral X-ray of the head: Deep brain stimulation in [[Obsessive–compulsive disorder]] (OCD). 42 year old man, surgery in 2013.|链接=Special:FilePath/X-ray_of_deep_brain_stimulation_in_OCD,_L.png]]
DBS治疗TRD与抗抑郁药一样有效，有良好的反应率和缓解率，但不良反应和安全性必须得到更全面的评估。常见的副作用包括“伤口感染、围手术期头痛、情绪恶化/烦躁以及自杀倾向增加”<ref name="Moreines" />。
DBS治疗TRD与抗抑郁药一样有效，有良好的反应率和缓解率，但不良反应和安全性必须得到更全面的评估。常见的副作用包括“伤口感染、围手术期头痛、情绪恶化/烦躁以及自杀倾向增加”<ref name="Moreines" />。
=== Other clinical applications ===
=== Other clinical applications(其他临床应用) ===
Results of DBS in people with dystonia, where positive effects often appear gradually over a period of weeks to months, indicate a role of functional reorganization in at least some cases.<ref name=":32">{{cite journal|vauthors = Krauss JK|title = Deep brain stimulation for dystonia in adults. Overview and developments|journal = Stereotactic and Functional Neurosurgery|volume = 78|issue = 3–4|pages = 168–82|year = 2002|pmid = 12652041|doi = 10.1159/000068963|s2cid = 71888143}}</ref> The procedure has been tested for effectiveness in people with [[epilepsy]] that is resistant to medication.<ref name=":33">{{cite journal|vauthors = Wu C, Sharan AD|title = Neurostimulation for the treatment of epilepsy: a review of current surgical interventions|journal = Neuromodulation|volume = 16|issue = 1|pages = 10–24; discussion 24|date = Jan–Feb 2013|pmid = 22947069|doi = 10.1111/j.1525-1403.2012.00501.x|s2cid = 1711587}}</ref> DBS may reduce or eliminate epileptic seizures with programmed or responsive stimulation.{{citation needed|date=January 2017}}
Results of DBS in people with dystonia, where positive effects often appear gradually over a period of weeks to months, indicate a role of functional reorganization in at least some cases.<ref name=":32">{{cite journal|vauthors = Krauss JK|title = Deep brain stimulation for dystonia in adults. Overview and developments|journal = Stereotactic and Functional Neurosurgery|volume = 78|issue = 3–4|pages = 168–82|year = 2002|pmid = 12652041|doi = 10.1159/000068963|s2cid = 71888143}}</ref> The procedure has been tested for effectiveness in people with [[epilepsy]] that is resistant to medication.<ref name=":33">{{cite journal|vauthors = Wu C, Sharan AD|title = Neurostimulation for the treatment of epilepsy: a review of current surgical interventions|journal = Neuromodulation|volume = 16|issue = 1|pages = 10–24; discussion 24|date = Jan–Feb 2013|pmid = 22947069|doi = 10.1111/j.1525-1403.2012.00501.x|s2cid = 1711587}}</ref> DBS may reduce or eliminate epileptic seizures with programmed or responsive stimulation.{{citation needed|date=January 2017}}
2016年，DBS被发现可以改善'''Rett综合征（[[Rett syndrome]]）'''小鼠模型的学习和记忆<ref name=":36" /> 。最近2018年的研究表明，穹穴DBS上调了涉及突触功能、细胞存活和神经发生的基因<ref name=":37" /> ，在解释海马回路功能的恢复方面迈出了一些第一步。
2016年，DBS被发现可以改善'''Rett综合征（[[Rett syndrome]]）'''小鼠模型的学习和记忆<ref name=":36" /> 。最近2018年的研究表明，穹穴DBS上调了涉及突触功能、细胞存活和神经发生的基因<ref name=":37" /> ，在解释海马回路功能的恢复方面迈出了一些第一步。
== See also ==
== See also(另请参阅) ==
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== References ==
== References(参考文献) ==
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== Further reading ==
== Further reading（延伸阅读） ==
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== External links ==
== External links（外部链接） ==
{{Commons category|Deep brain stimulation}}
{{Commons category|Deep brain stimulation}}