Neurostimulation Devices for the Treatment of Neurologic Disorders
Neurostimulation Devices for the Treatment of Neurologic Disorders
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DOI：
10.1016/j.mayocp.2017.05.005
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发表时间：
2017-09-01
影响因子：
8.9
通讯作者：
Ross, Erika K.
中科院分区：
文献类型：
--
作者：
Edwards, Christine A.;Kouzani, Abbas;Ross, Erika K.
神经刺激技术的快速进步正在为空前数量的患者提供缓解，这些患者受到衰弱的神经和精神障碍的影响。神经刺激疗法包括侵入性和非侵入性方法，涉及应用电刺激来驱动电路中的神经功能。这篇综述主要集中在已建立的侵入性电刺激系统，临床上用于诱导治疗神经回路功能障碍的神经调节。这些植入式神经刺激系统针对特定的皮质下、皮质、脊髓、颅骨和周围神经结构，以调节神经元活动，为无数神经精神疾病提供治疗效果。神经技术和神经成像技术的最新进展，以及对神经回路的了解的加深，是导致神经刺激疗法用于治疗越来越广泛的神经和精神疾病的快速增长的因素。电刺激技术在过去30年停滞不前后正在发展，朝着潜在的闭环系统治疗控制系统发展，该系统能够以更高的空间分辨率提供刺激，以提供连续的定制神经调节，以实现最佳的临床结果。即便如此，关于这些神经退行性和精神障碍的疾病发病机制以及神经刺激提供治疗缓解的潜在机制仍有许多需要了解。本文对日益常见的刺激系统、临床适应症和使能技术进行了综述。(C)2017年梅奥医学教育和研究基金会
Rapid advancements in neurostimulation technologies are providing relief to an unprecedented number of patients affected by debilitating neurologic and psychiatric disorders. Neurostimulation therapies include invasive and noninvasive approaches that involve the application of electrical stimulation to drive neural function within a circuit. This review focuses on established invasive electrical stimulation systems used clinically to induce therapeutic neuromodulation of dysfunctional neural circuitry. These implantable neurostimulation systems target specific deep subcortical, cortical, spinal, cranial, and peripheral nerve structures to modulate neuronal activity, providing therapeutic effects for a myriad of neuropsychiatric disorders. Recent advances in neurotechnologies and neuroimaging, along with an increased understanding of neurocircuitry, are factors contributing to the rapid rise in the use of neurostimulation therapies to treat an increasingly wide range of neurologic and psychiatric disorders. Electrical stimulation technologies are evolving after remaining fairly stagnant for the past 30 years, moving toward potential closed-loop therapeutic control systems with the ability to deliver stimulation with higher spatial resolution to provide continuous customized neuromodulation for optimal clinical outcomes. Even so, there is still much to be learned about disease pathogenesis of these neurodegenerative and psychiatric disorders and the latent mechanisms of neurostimulation that provide therapeutic relief. This review provides an overview of the increasingly common stimulation systems, their clinical indications, and enabling technologies. (C) 2017 Mayo Foundation for Medical Education and Research