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== Research ==

=== Chronic pain ===

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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>

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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 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.

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慢性疼痛刺激中脑导水管周围灰质和脑室周围灰质以治疗伤害性疼痛，内囊、腹外侧核和神经性疼痛内侧中央核对于一些人已经产生了令人印象深刻的结果，但是结果不一。一项对17名顽固性癌症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。大多数人最终依靠阿片类药物，通常是在生命的最后几周。DBS 也用于治疗幻肢痛。

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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 ===

[[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]]

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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>

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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 name=":24">{{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 name=":25">{{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 name=":26">{{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>

DBS has been used in a small number of clinical trials to treat people with severe treatment-resistant depression (TRD). A number of neuroanatomical targets have been used for DBS for TRD including the subgenual cingulate gyrus, posterior gyrus rectus, nucleus accumbens, ventral capsule/ventral striatum, inferior thalamic peduncle, and the lateral habenula. 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.

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~~DBS 已经在少数临床试验中用于治疗严重难治性抑郁症~~(TRD)~~患者。目前已有多种神经解剖学靶点用于视网膜下区(DBS) TRD 的研究，包括扣带回下部、直回后部、伏隔核、腹侧囊~~/~~腹侧纹状体、丘脑下端和外侧缰核。最近提出的 DBS 干预抑郁症的目标是前脑内侧神经束的上外侧分支~~; ~~它的刺激导致了惊人的快速抗抑郁作用。~~

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DBS已在少量临床试验中用于治疗严重'''难治性抑郁症（[[treatment-resistant depression]]）'''(TRD)患者<ref name="Anderson" /> 。DBS治疗TRD的神经解剖学靶点包括膝下扣带回、后直回<ref name=":24" />、伏隔核<ref name=":25" /> 、腹侧囊/腹侧纹状体、丘脑下蒂和外侧缰状核<ref name="Anderson" /> 。最近提出的DBS干预抑郁症的靶点是'''内侧前脑束（[[medial forebrain bundle]]）'''的上外侧支;它的刺激导致惊人的快速抗抑郁作用<ref name=":26" />。

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The small numbers in the early trials of DBS for TRD currently limit the selection of an optimal neuroanatomical target.<ref name="Anderson"/> Evidence is insufficient to support DBS as a therapeutic modality for depression; however, the procedure may be an effective [[treatment modality]] in the future.<ref>{{cite journal |last1=Murphy |first1=Destiny N. |last2=Boggio |first2=Paulo |last3=Fregni |first3=Felipe |title=Transcranial direct current stimulation as a therapeutic tool for the treatment of major depression: insights from past and recent clinical studies |journal=Curr Opin Psychiatry |year=2009 |volume=22 |issue=3 |pages=306–11 |doi=10.1097/YCO.0b013e32832a133f |pmid=19339889 |s2cid=11392351}}</ref> In fact, beneficial results have been documented in the neurosurgical literature, including a few instances in which people who were deeply depressed were provided with portable stimulators for self treatment.<ref name="Delgado 1986">{{cite book|last=Delgado|first=Jose|title=Physical Control of the Mind: Toward a Psychocivilized Society|year=1986|publisher=Harper and Row|location=New York |isbn=0-06-131914-7}}</ref><ref name="Faria 3">{{cite journal|vauthors = Faria MA|title = Violence, mental illness, and the brain – A brief history of psychosurgery: Part 3 – From deep brain stimulation to amygdalotomy for violent behavior, seizures, and pathological aggression in humans|journal = Surgical Neurology International|volume = 4|issue = 1|pages = 91|year = 2013|pmid = 23956934|pmc = 3740620|doi = 10.4103/2152-7806.115162}}</ref><ref>{{cite journal|vauthors = Robison RA, Taghva A, Liu CY, Apuzzo ML|title = Surgery of the mind, mood, and conscious state: an idea in evolution|journal = World Neurosurgery|volume = 77|issue = 5–6|pages = 662–86|year = 2012|pmid = 22446082|doi = 10.1016/j.wneu.2012.03.005}}</ref>

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The small numbers in the early trials of DBS for TRD currently limit the selection of an optimal neuroanatomical target.<ref name="Anderson"/> Evidence is insufficient to support DBS as a therapeutic modality for depression; however, the procedure may be an effective [[treatment modality]] in the future.<ref name=":27">{{cite journal |last1=Murphy |first1=Destiny N. |last2=Boggio |first2=Paulo |last3=Fregni |first3=Felipe |title=Transcranial direct current stimulation as a therapeutic tool for the treatment of major depression: insights from past and recent clinical studies |journal=Curr Opin Psychiatry |year=2009 |volume=22 |issue=3 |pages=306–11 |doi=10.1097/YCO.0b013e32832a133f |pmid=19339889 |s2cid=11392351}}</ref> In fact, beneficial results have been documented in the neurosurgical literature, including a few instances in which people who were deeply depressed were provided with portable stimulators for self treatment.<ref name="Delgado 1986">{{cite book|last=Delgado|first=Jose|title=Physical Control of the Mind: Toward a Psychocivilized Society|year=1986|publisher=Harper and Row|location=New York |isbn=0-06-131914-7}}</ref><ref name="Faria 3">{{cite journal|vauthors = Faria MA|title = Violence, mental illness, and the brain – A brief history of psychosurgery: Part 3 – From deep brain stimulation to amygdalotomy for violent behavior, seizures, and pathological aggression in humans|journal = Surgical Neurology International|volume = 4|issue = 1|pages = 91|year = 2013|pmid = 23956934|pmc = 3740620|doi = 10.4103/2152-7806.115162}}</ref><ref name=":28">{{cite journal|vauthors = Robison RA, Taghva A, Liu CY, Apuzzo ML|title = Surgery of the mind, mood, and conscious state: an idea in evolution|journal = World Neurosurgery|volume = 77|issue = 5–6|pages = 662–86|year = 2012|pmid = 22446082|doi = 10.1016/j.wneu.2012.03.005}}</ref>

The small numbers in the early trials of DBS for TRD currently limit the selection of an optimal neuroanatomical target. Evidence is insufficient to support DBS as a therapeutic modality for depression; however, the procedure may be an effective treatment modality in the future. In fact, beneficial results have been documented in the neurosurgical literature, including a few instances in which people who were deeply depressed were provided with portable stimulators for self treatment.

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DBS 治疗 TRD 的早期试验数量较少，目前限制了最佳神经解剖靶点的选择。证据不足以支持 DBS 作为抑郁症的治疗方式，但是，该程序可能是一个有效的治疗方式在未来。事实上，神经外科文献已经记录了有益的结果，包括一些深度抑郁患者获得便携式刺激器进行自我治疗的例子。

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DBS治疗TRD的早期试验数量较少，目前限制了最佳神经解剖学靶点的选择<ref name="Anderson" /> 。证据不足以支持DBS作为抑郁症的治疗方式;然而，该手术可能是未来一种有效的治疗方式（[[treatment modality]]）<ref name=":27" />。事实上，神经外科文献中已经记录了有益的结果，包括一些为重度抑郁的人提供便携式刺激器进行自我治疗的例子<ref name="Delgado 1986" /><ref name="Faria 3" /><ref name=":28" />。

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A systematic review of DBS for TRD and OCD identified 23 cases, nine for OCD, seven for TRD, and one for both. "[A]bout half the patients did show dramatic improvement" and adverse events were "generally trivial" given the younger age of the psychiatric population relative to the age of people with movement disorders.<ref name=Lakhan>{{cite journal|vauthors = Lakhan SE, Callaway E|title = Deep brain stimulation for obsessive-compulsive disorder and treatment-resistant depression: systematic review|journal = BMC Research Notes|volume = 3|issue = 1|pages = 60|date = March 2010|pmid = 20202203|pmc = 2838907|doi = 10.1186/1756-0500-3-60}}</ref> The first randomized, controlled study of DBS for the treatment of TRD targeting the ventral capsule/ventral striatum area did not demonstrate a significant difference in response rates between the active and sham groups at the end of a 16-week study.<ref>{{cite journal|vauthors = Dougherty DD, Rezai AR, Carpenter LL, Howland RH, Bhati MT, O'Reardon JP, Eskandar EN, Baltuch GH, Machado AD, Kondziolka D, Cusin C, Evans KC, Price LH, Jacobs K, Pandya M, Denko T, Tyrka AR, Brelje T, Deckersbach T, Kubu C, Malone DA|title = A Randomized Sham-Controlled Trial of Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Chronic Treatment-Resistant Depression|journal = Biological Psychiatry|volume = 78|issue = 4|pages = 240–48|date = August 2015|pmid = 25726497|doi = 10.1016/j.biopsych.2014.11.023|s2cid = 22644265}}</ref> However, a second randomized controlled study of ventral capsule DBS for TRD did demonstrate a significant difference in response rates between active DBS (44% responders) and sham DBS (0% responders).<ref>{{cite journal|vauthors = Bergfeld IO, Mantione M, Hoogendoorn ML, Ruhé HG, Notten P, van Laarhoven J, Visser I, Figee M, de Kwaasteniet BP, Horst F, Schene AH, van den Munckhof P, Beute G, Schuurman R, Denys D|display-authors = 6|title = Deep Brain Stimulation of the Ventral Anterior Limb of the Internal Capsule for Treatment-Resistant Depression: A Randomized Clinical Trial|journal = JAMA Psychiatry|volume = 73|issue = 5|pages = 456–64|date = May 2016|pmid = 27049915|doi = 10.1001/jamapsychiatry.2016.0152|doi-access = free}}</ref> Efficacy of DBS is established for OCD, with on average 60% responders in severely ill and treatment-resistant patients.<ref>{{cite journal|vauthors = Alonso P, Cuadras D, Gabriëls L, Denys D, Goodman W, Greenberg BD, Jimenez-Ponce F, Kuhn J, Lenartz D, Mallet L, Nuttin B, Real E, Segalas C, Schuurman R, du Montcel ST, Menchon JM|display-authors = 6|title = Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Meta-Analysis of Treatment Outcome and Predictors of Response|journal = PLOS ONE|volume = 10|issue = 7|pages = e0133591|date = 2015-07-24|pmid = 26208305|pmc = 4514753|doi = 10.1371/journal.pone.0133591|bibcode = 2015PLoSO..1033591A|doi-access = free}}</ref> Based on these results the [[Food and Drug Administration]] (FDA) has approved DBS for treatment-resistant OCD under a Humanitarian Device Exemption (HDE), requiring that the procedure be performed only in a hospital with specialist qualifications to do so.

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A systematic review of DBS for TRD and OCD identified 23 cases, nine for OCD, seven for TRD, and one for both. "[A]bout half the patients did show dramatic improvement" and adverse events were "generally trivial" given the younger age of the psychiatric population relative to the age of people with movement disorders.<ref name=Lakhan>{{cite journal|vauthors = Lakhan SE, Callaway E|title = Deep brain stimulation for obsessive-compulsive disorder and treatment-resistant depression: systematic review|journal = BMC Research Notes|volume = 3|issue = 1|pages = 60|date = March 2010|pmid = 20202203|pmc = 2838907|doi = 10.1186/1756-0500-3-60}}</ref> The first randomized, controlled study of DBS for the treatment of TRD targeting the ventral capsule/ventral striatum area did not demonstrate a significant difference in response rates between the active and sham groups at the end of a 16-week study.<ref name=":29">{{cite journal|vauthors = Dougherty DD, Rezai AR, Carpenter LL, Howland RH, Bhati MT, O'Reardon JP, Eskandar EN, Baltuch GH, Machado AD, Kondziolka D, Cusin C, Evans KC, Price LH, Jacobs K, Pandya M, Denko T, Tyrka AR, Brelje T, Deckersbach T, Kubu C, Malone DA|title = A Randomized Sham-Controlled Trial of Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Chronic Treatment-Resistant Depression|journal = Biological Psychiatry|volume = 78|issue = 4|pages = 240–48|date = August 2015|pmid = 25726497|doi = 10.1016/j.biopsych.2014.11.023|s2cid = 22644265}}</ref> However, a second randomized controlled study of ventral capsule DBS for TRD did demonstrate a significant difference in response rates between active DBS (44% responders) and sham DBS (0% responders).<ref name=":30">{{cite journal|vauthors = Bergfeld IO, Mantione M, Hoogendoorn ML, Ruhé HG, Notten P, van Laarhoven J, Visser I, Figee M, de Kwaasteniet BP, Horst F, Schene AH, van den Munckhof P, Beute G, Schuurman R, Denys D|display-authors = 6|title = Deep Brain Stimulation of the Ventral Anterior Limb of the Internal Capsule for Treatment-Resistant Depression: A Randomized Clinical Trial|journal = JAMA Psychiatry|volume = 73|issue = 5|pages = 456–64|date = May 2016|pmid = 27049915|doi = 10.1001/jamapsychiatry.2016.0152|doi-access = free}}</ref> Efficacy of DBS is established for OCD, with on average 60% responders in severely ill and treatment-resistant patients.<ref name=":31">{{cite journal|vauthors = Alonso P, Cuadras D, Gabriëls L, Denys D, Goodman W, Greenberg BD, Jimenez-Ponce F, Kuhn J, Lenartz D, Mallet L, Nuttin B, Real E, Segalas C, Schuurman R, du Montcel ST, Menchon JM|display-authors = 6|title = Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Meta-Analysis of Treatment Outcome and Predictors of Response|journal = PLOS ONE|volume = 10|issue = 7|pages = e0133591|date = 2015-07-24|pmid = 26208305|pmc = 4514753|doi = 10.1371/journal.pone.0133591|bibcode = 2015PLoSO..1033591A|doi-access = free}}</ref> Based on these results the [[Food and Drug Administration]] (FDA) has approved DBS for treatment-resistant OCD under a Humanitarian Device Exemption (HDE), requiring that the procedure be performed only in a hospital with specialist qualifications to do so.

A systematic review of DBS for TRD and OCD identified 23 cases, nine for OCD, seven for TRD, and one for both. "[A]bout half the patients did show dramatic improvement" and adverse events were "generally trivial" given the younger age of the psychiatric population relative to the age of people with movement disorders. The first randomized, controlled study of DBS for the treatment of TRD targeting the ventral capsule/ventral striatum area did not demonstrate a significant difference in response rates between the active and sham groups at the end of a 16-week study. However, a second randomized controlled study of ventral capsule DBS for TRD did demonstrate a significant difference in response rates between active DBS (44% responders) and sham DBS (0% responders). Efficacy of DBS is established for OCD, with on average 60% responders in severely ill and treatment-resistant patients. Based on these results the Food and Drug Administration (FDA) has approved DBS for treatment-resistant OCD under a Humanitarian Device Exemption (HDE), requiring that the procedure be performed only in a hospital with specialist qualifications to do so.

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一项针对 TRD 和 OCD 的深部脑震荡系统综述确诊了23例，其中9例为强迫症，7例为 TRD，还有一例两者都有。“一半的病人确实显示出了显著的改善”，并且不良事件“通常是微不足道的”，因为相对于运动障碍患者的年龄来说，精神病患者的年龄更小。在一项为期16周的研究结束时，针对腹侧被膜/腹侧纹状体区域的 DBS 治疗 TRD 的首次随机对照研究并没有显示活跃组和假手术组的有效率有显著差异。然而，第二个随机对照研究腹腔胶囊 DBS 治疗 TRD 的结果显示，活动性 DBS (44% ~~有效者~~)~~和假 DBS~~ (0% ~~有效者~~)~~的有效率有显著差异。DBS 对强迫症的疗效已经确立，在重症患者和难治性患者中平均有60~~% ~~的反应。基于这些结果，美国食品和药物管理局~~(FDA)根据人道主义器械豁免(HDE)~~批准 DBS 用于耐药性强迫症，要求只有在具有专家资格的医院才能进行这种手术。~~

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一项针对TRD和OCD的系统回顾发现了23例DBS, 9例为OCD, 7例为TRD, 1例为两者。“大约一半的患者确实表现出了显著的改善”，而且考虑到精神病患者的年龄相对于运动障碍患者的年龄，不良事件“通常微不足道”<ref name="Lakhan" /> 。在第一个随机对照研究中，DBS用于治疗以腹侧囊/腹侧纹状体区域为靶点的TRD，在16周的研究结束时，active组和sham组之间的缓解率没有显著差异<ref name=":29" />。然而，另一项腹侧胶囊DBS治疗TRD的随机对照研究确实表明，有效DBS(有效率为44%)和假DBS(有效率为0%)的缓解率存在显著差异)<ref name=":30" /> 。DBS治疗强迫症疗效显著，重症和难治性患者平均有效率为60%<ref name=":31" />。根据这些结果，美国'''食品和药物管理局（[[Food and Drug Administration]] ）'''(FDA)根据人道主义器械豁免(HDE)批准了DBS治疗顽症，要求只有在有专业资格的医院才能实施该手术。

DBS for TRD can be as effective as antidepressants and can have good response and remission rates, but adverse effects and safety must be more fully evaluated. Common side effects include "wound infection, perioperative headache, and worsening/irritable mood [and] increased suicidality".<ref name=Moreines>{{cite journal|vauthors = Moreines JL, McClintock SM, Holtzheimer PE|title = Neuropsychologic effects of neuromodulation techniques for treatment-resistant depression: a review|journal = Brain Stimulation|volume = 4|issue = 1|pages = 17–27|date = January 2011|pmid = 21255751|pmc = 3023999|doi = 10.1016/j.brs.2010.01.005}}</ref>

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DBS for TRD can be as effective as antidepressants and can have good response and remission rates, but adverse effects and safety must be more fully evaluated. Common side effects include "wound infection, perioperative headache, and worsening/irritable mood [and] increased suicidality".

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DBS 治疗 TRD 可以和抗抑郁药物一样有效，并且有良好的反应和缓解率，但是不良反应和安全性必须进行更充分的评估。常见的副作用包括“伤口感染、围手术期头痛、情绪恶化/~~易激情绪[和]自杀倾向增加”。~~

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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 ===

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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>{{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>{{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}}

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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. The procedure has been tested for effectiveness in people with epilepsy that is resistant to medication. DBS may reduce or eliminate epileptic seizures with programmed or responsive stimulation.

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在肌张力障碍患者中 DBS 的其他临床应用结果，其积极作用通常在数周至数月内逐渐显现，至少在某些情况下表明了功能重组的作用。这种方法已经在对药物耐药的癫痫患者身上进行了有效性测试。DBS 可以通过程序性或反应性刺激减少或消除癫痫发作。

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DBS对肌张力障碍患者的治疗结果显示，积极效果往往在数周至数月的时间内逐渐显现，至少在某些情况下显示出功能重组的作用<ref name=":32" /> 。该方法已经在对药物有抗药性的'''癫痫（[[epilepsy]]）'''患者身上进行了有效性测试<ref name=":33" /> 。DBS可通过程序性或反应性刺激减少或消除癫痫发作.{{citation needed|date=January 2017}}。

DBS of the [[Septal nuclei|septal areas]] of persons with [[schizophrenia]] have resulted in enhanced alertness, cooperation, and euphoria.<ref>{{cite journal|vauthors = Heath RG|title = Pleasure and brain activity in man. Deep and surface electroencephalograms during orgasm|journal = The Journal of Nervous and Mental Disease|volume = 154|issue = 1|pages = 3–18|date = January 1972|pmid = 5007439|doi = 10.1097/00005053-197201000-00002|s2cid = 136706}}</ref> Persons with [[narcolepsy]] and [[complex-partial seizures]] also reported euphoria and sexual thoughts from self-elicited DBS of the septal nuclei.<ref name="Faria 3" />

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DBS of the septal areas of persons with schizophrenia have resulted in enhanced alertness, cooperation, and euphoria. Persons with narcolepsy and complex-partial seizures also reported euphoria and sexual thoughts from self-elicited DBS of the septal nuclei.

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精神分裂症患者的房间隔区域的 DBS 导致了警觉性、合作性和欣快感的增强。嗜睡症和复杂部分癫痫患者也报告了自我诱发的隔核 DBS 所引起的欣快感和性想法。

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对'''精神分裂症患者（[[schizophrenia]]）'''的'''鼻中隔区域（[[Septal nuclei|septal areas]]）'''进行DBS可增强警惕性、合作性和欣快感<ref name=":32" /> 。有'''嗜睡症（[[narcolepsy]] ）'''和'''复杂部分性癫痫（[[complex-partial seizures]]）'''的患者也报告说，自我诱发的间隔核深部脑刺激能产生欣快感和性想法<ref name="Faria 3" />。

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Orgasmic ecstasy was reported with the electrical stimulation of the brain with depth electrodes in the left [[hippocampus]] at 3mA, and the right [[hippocampus]] at 1 mA.<ref>{{cite journal|vauthors = Surbeck W, Bouthillier A, Nguyen DK|title = Bilateral cortical representation of orgasmic ecstasy localized by depth electrodes|journal = Epilepsy & Behavior Case Reports|volume = 1|pages = 62–65|pmid = 25667829|pmc = 4150648|doi = 10.1016/j.ebcr.2013.03.002|year = 2013}}</ref>

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Orgasmic ecstasy was reported with the electrical stimulation of the brain with depth electrodes in the left [[hippocampus]] at 3mA, and the right [[hippocampus]] at 1 mA.<ref name=":34">{{cite journal|vauthors = Surbeck W, Bouthillier A, Nguyen DK|title = Bilateral cortical representation of orgasmic ecstasy localized by depth electrodes|journal = Epilepsy & Behavior Case Reports|volume = 1|pages = 62–65|pmid = 25667829|pmc = 4150648|doi = 10.1016/j.ebcr.2013.03.002|year = 2013}}</ref>

Orgasmic ecstasy was reported with the electrical stimulation of the brain with depth electrodes in the left hippocampus at 3mA, and the right hippocampus at 1 mA.

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~~用深度电极电刺激大脑左侧海马3毫安，右侧海马1毫安。~~

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据报道，通过深度电极对大脑进行电刺激，左侧'''海马体（ [[hippocampus]] ）'''为3毫安，右侧'''海马体（[[hippocampus]]）'''为1毫安<ref name=":34" />。

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In 2015, a group of Brazilian researchers led by neurosurgeon {{ill|Erich Fonoff|pt|Erich Fonoff}} described a new technique that allows for simultaneous implants of electrodes called bilateral stereotactic procedure for DBS. The main benefits are less time spent on the procedure and greater accuracy.<ref>{{cite journal|vauthors = Fonoff ET, Azevedo A, Angelos JS, Martinez RC, Navarro J, Reis PR, Sepulveda ME, Cury RG, Ghilardi MG, Teixeira MJ, Lopez WO|title = Simultaneous bilateral stereotactic procedure for deep brain stimulation implants: a significant step for reducing operation time|journal = Journal of Neurosurgery|volume = 125|issue = 1|pages = 85–89|date = July 2016|pmid = 26684776|doi = 10.3171/2015.7.JNS151026|doi-access = free}}</ref>

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In 2015, a group of Brazilian researchers led by neurosurgeon {{ill|Erich Fonoff|pt|Erich Fonoff}} described a new technique that allows for simultaneous implants of electrodes called bilateral stereotactic procedure for DBS. The main benefits are less time spent on the procedure and greater accuracy.<ref name=":35">{{cite journal|vauthors = Fonoff ET, Azevedo A, Angelos JS, Martinez RC, Navarro J, Reis PR, Sepulveda ME, Cury RG, Ghilardi MG, Teixeira MJ, Lopez WO|title = Simultaneous bilateral stereotactic procedure for deep brain stimulation implants: a significant step for reducing operation time|journal = Journal of Neurosurgery|volume = 125|issue = 1|pages = 85–89|date = July 2016|pmid = 26684776|doi = 10.3171/2015.7.JNS151026|doi-access = free}}</ref>

In 2015, a group of Brazilian researchers led by neurosurgeon described a new technique that allows for simultaneous implants of electrodes called bilateral stereotactic procedure for DBS. The main benefits are less time spent on the procedure and greater accuracy.

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2015年，由神经外科医生领导的一组巴西研究人员描述了一种新技术，该技术允许同时植入电极，称为 DBS 的双侧立体定向手术。主要的好处是花在手术上的时间更少，而且更准确。

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2015年，由神经外科医生领导的一组巴西研究人员描述了一种新技术，该技术允许同时植入电极，称为双侧立体定向术。主要的好处是花在手术上的时间更少，准确性更高<ref name=":35" />。

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In 2016, DBS was found to improve learning and memory in a mouse model of [[Rett syndrome]].<ref>{{cite journal|vauthors = Lu H, Ash RT, He L, Kee SE, Wang W, Yu D, Hao S, Meng X, Ure K, Ito-Ishida A, Tang B, Sun Y, Ji D, Tang J, Arenkiel BR, Smirnakis SM, Zoghbi HY|title = Loss and Gain of MeCP2 Cause Similar Hippocampal Circuit Dysfunction that Is Rescued by Deep Brain Stimulation in a Rett Syndrome Mouse Model|journal = Neuron|volume = 91|issue = 4|pages = 739–47|date = August 2016|pmid = 27499081|pmc = 5019177|doi = 10.1016/j.neuron.2016.07.018}}</ref> More recent (2018) work showed, that forniceal DBS upregulates genes involved in synaptic function, cell survival, and neurogenesis,<ref>{{cite journal|vauthors = Pohodich AE, Yalamanchili H, Raman AT, Wan YW, Gundry M, Hao S, Jin H, Tang J, Liu Z, Zoghbi HY|title = Forniceal deep brain stimulation induces gene expression and splicing changes that promote neurogenesis and plasticity|journal = eLife|volume = 7|date = March 2018|pmid = 29570050|pmc = 5906096|doi = 10.7554/elife.34031}}</ref> making some first steps at explaining the restoration of hippocampal circuit function.

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In 2016, DBS was found to improve learning and memory in a mouse model of [[Rett syndrome]].<ref name=":36">{{cite journal|vauthors = Lu H, Ash RT, He L, Kee SE, Wang W, Yu D, Hao S, Meng X, Ure K, Ito-Ishida A, Tang B, Sun Y, Ji D, Tang J, Arenkiel BR, Smirnakis SM, Zoghbi HY|title = Loss and Gain of MeCP2 Cause Similar Hippocampal Circuit Dysfunction that Is Rescued by Deep Brain Stimulation in a Rett Syndrome Mouse Model|journal = Neuron|volume = 91|issue = 4|pages = 739–47|date = August 2016|pmid = 27499081|pmc = 5019177|doi = 10.1016/j.neuron.2016.07.018}}</ref> More recent (2018) work showed, that forniceal DBS upregulates genes involved in synaptic function, cell survival, and neurogenesis,<ref name=":37">{{cite journal|vauthors = Pohodich AE, Yalamanchili H, Raman AT, Wan YW, Gundry M, Hao S, Jin H, Tang J, Liu Z, Zoghbi HY|title = Forniceal deep brain stimulation induces gene expression and splicing changes that promote neurogenesis and plasticity|journal = eLife|volume = 7|date = March 2018|pmid = 29570050|pmc = 5906096|doi = 10.7554/elife.34031}}</ref> making some first steps at explaining the restoration of hippocampal circuit function.

In 2016, DBS was found to improve learning and memory in a mouse model of Rett syndrome. More recent (2018) work showed, that forniceal DBS upregulates genes involved in synaptic function, cell survival, and neurogenesis, making some first steps at explaining the restoration of hippocampal circuit function.

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2016年，在一个瑞特综合征小鼠模型中，发现 DBS 能改善学习和记忆。最近(2018年)的研究表明，私通 DBS 上调了与突触功能、细胞存活和神经发生有关的基因，为解释海马回路功能的恢复迈出了第一步。

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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 ==

喵喵子

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