脑深部电刺激的临床应用

脑深部电刺激(deep brain stimulation,DBS)是近20年来神经外科领域发展最迅猛的技术。DBS是通过刺激发生器发出的高频电脉冲信号刺激脑神经核团或神经传导束来调节异常的神经环路。DBS已经成为治疗特发性震颤、帕金森病、肌张力障碍等运动障碍病的常规手术方法。自1997年深部脑刺激通过美国FDA认证用于治疗特发性震颤以来,已有超过数万名运动障碍患者接受该疗法,而国内脑深部电刺激最早在1999年应用于帕金森病临床治疗,迄今也有数千例患者接受了植入手术。近年,脑起搏器的临床适应症不断扩大,从最初的运动障碍病逐渐发展到治疗其他神经和精神疾病,如抽动秽语综合征、强迫症、抑郁症、神经性厌食症、难治性疼痛、癫痫、植物状态和阿尔茨海默病等,虽然DBS的治疗机理还不很清楚,但可以预见未来DBS将成为众多神经和精神疾病的重要治疗方法。

Clinical application of deep brain stimulation

Deep brain stimulation （DBS） has achieved great development in the field of neurosurgery technology during the past 20 years. DBS plays a role in the regulation of neuro-circle by sending high-frequency impulses to stimulate the brain nuclei or nerve conduction. DBS has been a common therapy in the treatment of essential tremor （ET）, Parkinson＇s disease （PD） and dystonia. Tens of thousands of patients with movement disorders have underwent DBS therapy since the its approval for ET treatment by FDA in 1997. In China, the first DBS was performed in PD patient in 1999. Since then, thousands of patients with movement disorders have received the DBS implants. The indications of DBS have been expanded from the movement disorders to other neurological and psychiatric diseases, such as Tourette＇s syndrome, obsessive-compulsive disorder, depression, anorexia nervosa, refractory pain, epilepsy, vegetative state and Alzheimer＇s disease. Although the mechanism of DBS remains unclear, DBS will become an important alternative therapy for most neuropsychiatric disorders in future.