更改

深部脑刺激 (查看源代码)

2022年4月3日 (日) 20:16的版本

添加859字节、 2022年4月3日 (日) 20:16

无编辑摘要

第1行：第1行： +

此词条由神经动力学读书会词条梳理志愿者苏苏Anny翻译审校，未经专家审核，带来阅读不便，请见谅。

+

此词条暂由彩云小译翻译，翻译字数共2470，未经人工整理和审校，带来阅读不便，请见谅。

第29行：第31行：

Deep brain stimulation (DBS) is a neurosurgical procedure involving the placement of a medical device called a neurostimulator, which sends electrical impulses, through implanted electrodes, to specific targets in the brain (the brain nucleus) for the treatment of movement disorders, including Parkinson's disease, essential tremor, dystonia, and other conditions such as obsessive-compulsive disorder (OCD) and epilepsy. While its underlying principles and mechanisms are not fully understood, DBS directly changes brain activity in a controlled manner.

−

脑深部电刺激(DBS)~~是一种神经外科手术，包括放置一种叫做神经刺激器的医疗设备，通过植入的电极将电脉冲发送到大脑中的特定目标~~(脑核) ，用于治疗运动障碍，包括帕金森病、原发性震颤、肌张力障碍和其他疾病，如强迫症和癫痫。虽然其基本原理和机制尚不完全清楚，DBS 直接改变大脑活动在一个可控的方式。

+

脑深部电刺激(DBS)是神经外科手术（[[neurosurgery|neurosurgical]])中的操作之一，包括放置一种叫做神经刺激器( [[neurostimulator]])的医疗设备，通过植入的电极([[electrode]])将电脉冲发送到大脑([[brain]])中的特定目标(脑核([[Nucleus (neuroanatomy)|brain nucleus]])) ，治疗包括帕金森病([[Parkinson's disease]])、原发性震颤([[essential tremor]])、肌张力障碍([[dystonia]])<ref name="Kringelbach" />和其他疾病，如强迫症([[Obsessive–compulsive disorder|obsessive-compulsive disorder]])和癫痫([[epilepsy]])，引起的运动障碍。虽然其基本原理和机制尚不完全清楚，DBS 是一种可控的直接改变大脑活动的方式.<ref name="Hammond" /><ref name="garcia" />。

−

DBS has been approved by the [[Food and Drug Administration]] as a treatment for essential tremor and [[Parkinson's disease]] (PD) since 1997.<ref>{{Cite web|url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm451152.htm|title= FDA approves brain implant to help reduce Parkinson's disease and essential tremor symptoms|website=FDA|access-date=May 23, 2016|quote=The first device, Medtronic’s Activa Deep Brain Stimulation Therapy System, was approved in 1997 for tremor associated with essential tremor and Parkinson’s disease.}}</ref> DBS was approved for [[dystonia]] in 2003,<ref>[http://knbc-tvhealth.ip2m.com/index.cfm?pt=itemDetail&item_id=97349&site_cat_id=470 'Brain pacemaker' treats dystonia.] KNBC TV, April 22, 2003. Retrieved October 18, 2006.</ref> Obsessive–compulsive disorder (OCD) in 2009, and [[epilepsy]] in 2018.<ref>{{Cite web|url=http://newsroom.medtronic.com/phoenix.zhtml?c=251324&p=irol-newsArticle&ID=2345882|title= Medtronic Receives FDA Approval for Deep Brain Stimulation Therapy for Medically Refractory Epilepsy|website=newsroom.medtronic.com|access-date=2018-12-18}}</ref><ref>{{cite web|url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm149529.htm|title=FDA Approves Humanitarian Device Exemption for Deep Brain Stimulator for Severe Obsessive-Compulsive Disorder|work=FDA}}</ref><ref name=gildenberg>{{cite journal|vauthors = Gildenberg PL|title = Evolution of neuromodulation|journal = Stereotactic and Functional Neurosurgery|volume = 83|issue = 2–3|pages = 71–79|year = 2005|pmid = 16006778|doi = 10.1159/000086865|s2cid = 20234898}}</ref> DBS has been studied in clinical trials as a potential treatment for [[chronic pain]] for various affective disorders, including [[major depressive disorder|major depression]]. It is one of few neurosurgical procedures that allow [[Blind experiment|blinded studies]].<ref name="Kringelbach"/>

+

DBS has been approved by the [[Food and Drug Administration]] as a treatment for essential tremor and [[Parkinson's disease]] (PD) since 1997.<ref name=":0">{{Cite web|url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm451152.htm|title= FDA approves brain implant to help reduce Parkinson's disease and essential tremor symptoms|website=FDA|access-date=May 23, 2016|quote=The first device, Medtronic’s Activa Deep Brain Stimulation Therapy System, was approved in 1997 for tremor associated with essential tremor and Parkinson’s disease.}}</ref> DBS was approved for [[dystonia]] in 2003,<ref name=":1">[http://knbc-tvhealth.ip2m.com/index.cfm?pt=itemDetail&item_id=97349&site_cat_id=470 'Brain pacemaker' treats dystonia.] KNBC TV, April 22, 2003. Retrieved October 18, 2006.</ref> Obsessive–compulsive disorder (OCD) in 2009, and [[epilepsy]] in 2018.<ref name=":2">{{Cite web|url=http://newsroom.medtronic.com/phoenix.zhtml?c=251324&p=irol-newsArticle&ID=2345882|title= Medtronic Receives FDA Approval for Deep Brain Stimulation Therapy for Medically Refractory Epilepsy|website=newsroom.medtronic.com|access-date=2018-12-18}}</ref><ref name=":3">{{cite web|url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm149529.htm|title=FDA Approves Humanitarian Device Exemption for Deep Brain Stimulator for Severe Obsessive-Compulsive Disorder|work=FDA}}</ref><ref name=gildenberg>{{cite journal|vauthors = Gildenberg PL|title = Evolution of neuromodulation|journal = Stereotactic and Functional Neurosurgery|volume = 83|issue = 2–3|pages = 71–79|year = 2005|pmid = 16006778|doi = 10.1159/000086865|s2cid = 20234898}}</ref> DBS has been studied in clinical trials as a potential treatment for [[chronic pain]] for various affective disorders, including [[major depressive disorder|major depression]]. It is one of few neurosurgical procedures that allow [[Blind experiment|blinded studies]].<ref name="Kringelbach"/>

DBS has been approved by the Food and Drug Administration as a treatment for essential tremor and Parkinson's disease (PD) since 1997. DBS was approved for dystonia in 2003,'Brain pacemaker' treats dystonia. KNBC TV, April 22, 2003. Retrieved October 18, 2006. Obsessive–compulsive disorder (OCD) in 2009, and epilepsy in 2018. DBS has been studied in clinical trials as a potential treatment for chronic pain for various affective disorders, including major depression. It is one of few neurosurgical procedures that allow blinded studies.

−

~~自1997年以来，DBS 已经被美国食品和药物管理局批准用于治疗原发性震颤和帕金森病。2003年 DBS 被批准用于肌张力障碍，脑起搏器治疗肌张力障碍。KNBC~~ 电视台，2003年4月22日。18,~~2006.2009年是强迫症，2018年是癫痫。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)的慢性疼痛的潜在治疗方法。这是少数允许盲法研究的神经外科手术之一。

+

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" />。“脑起搏器”治疗肌张力障碍。KNBC 电视台，2003年4月22日。18,2006。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)的慢性疼痛的潜在治疗方法。这是少数允许盲法研究的神经外科手术之一。

== Medical use ==

−

[[Image:Parkinson surgery.jpg|thumb|250px|Insertion of electrode during surgery using a [[Stereotactic surgery|stereotactic frame]]]]

+

=== Parkinson's disease ===

第71行：第73行：

−

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>[[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.

第90行：第92行：

== Adverse effects ==

−

[[File:Mra1.jpg|thumb|left|Arteriogram of the arterial supply that can hemorrhage during DBS implantation.]]

+

[[File:Mra1.jpg|thumb|left|Arteriogram of the arterial supply that can hemorrhage during DBS implantation.|链接=Special:FilePath/Mra1.jpg]]

thumb|left|Arteriogram of the arterial supply that can hemorrhage during DBS implantation.

第172行：第174行：

== Research ==

=== Chronic pain ===

−

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>{{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>{{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 gray for nociceptive pain, and the internal capsule, ventral posterolateral nucleus, and ventral posteromedial nucleus for neuropathic pain has produced impressive results with some people, but results vary. One study 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. DBS has also been applied for phantom limb pain.

第179行：第181行：

=== Major depression and obsessive-compulsive disorder ===

−

[[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.]]

+

[[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 has been used in a small number of clinical trials to treat people with severe [[treatment-resistant depression]] (TRD).<ref name="Anderson">{{cite journal|vauthors = Anderson RJ, Frye MA, Abulseoud OA, Lee KH, McGillivray JA, Berk M, Tye SJ|title = Deep brain stimulation for treatment-resistant depression: efficacy, safety and mechanisms of action|journal = Neuroscience and Biobehavioral Reviews|volume = 36|issue = 8|pages = 1920–33|date = September 2012|pmid = 22721950|doi = 10.1016/j.neubiorev.2012.06.001|s2cid = 207089716}}</ref> A number of neuroanatomical targets have been used for DBS for TRD including the subgenual cingulate gyrus, posterior gyrus rectus,<ref>{{cite journal|vauthors = Accolla EA, Aust S, Merkl A, Schneider GH, Kühn AA, Bajbouj M, Draganski B|title = Deep brain stimulation of the posterior gyrus rectus region for treatment resistant depression|journal = Journal of Affective Disorders|volume = 194|pages = 33–37|date = April 2016|pmid = 26802505|doi = 10.1016/j.jad.2016.01.022|doi-access = free}}</ref> [[nucleus accumbens]],<ref>{{cite journal|vauthors = Schlaepfer TE, Cohen MX, Frick C, Kosel M, Brodesser D, Axmacher N, Joe AY, Kreft M, Lenartz D, Sturm V|title = Deep brain stimulation to reward circuitry alleviates anhedonia in refractory major depression|journal = Neuropsychopharmacology|volume = 33|issue = 2|pages = 368–77|date = January 2008|pmid = 17429407|doi = 10.1038/sj.npp.1301408|doi-access = free}}</ref> ventral capsule/ventral striatum, inferior thalamic peduncle, and the lateral habenula.<ref name="Anderson"/> A recently proposed target of DBS intervention in depression is the superolateral branch of the [[medial forebrain bundle]]; its stimulation lead to surprisingly rapid antidepressant effects.<ref>{{cite journal|vauthors = Schlaepfer TE, Bewernick BH, Kayser S, Mädler B, Coenen VA|title = Rapid effects of deep brain stimulation for treatment-resistant major depression|journal = Biological Psychiatry|volume = 73|issue = 12|pages = 1204–12|date = June 2013|pmid = 23562618|doi = 10.1016/j.biopsych.2013.01.034|s2cid = 6374368}}</ref>

苏苏Anny

5

个编辑