Developing Precision Invasive Neuromodulation for Psychiatry.
Developing Precision Invasive Neuromodulation for Psychiatry.
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DOI：
10.1176/appi.neuropsych.20100268
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Boes AD
中科院分区：
文献类型：
--
作者：
Bormann NL;Trapp NT;Narayanan NS;Boes AD
精神疾病很常见，而且常常致残。尽管药物治疗和心理治疗方法在缓解症状方面取得了很大进展，但尽管有最好的治疗方法，许多患者仍然有严重的疾病负担。改善治疗的普遍挑战之一是目前的诊断和治疗策略落后于我们对这些疾病的病理生理学的现代概念化。精神病症状通过特定神经回路的活动表现出来;因此，能够调节这些回路的疗法是有吸引力的。研究人员回顾了最近的进展，这些进展有助于以更直接干预基础病理生理学的方式通过颅内神经调节治疗难治性精神疾病。具体而言，他们回顾了使用颅内多电极阵列以高时空分辨率记录大脑活动并识别症状的电路水平电生理相关性的前景。然后可以通过调节电路来破坏症状来建立电路电生理学与症状的因果关系。然后，个性化的治疗性神经调节策略可以以合理的方式进行，其中刺激方案由最令人烦恼的症状的基于基础电路的病理生理学告知。这一策略将通过识别具有特定神经元精确度的个体化解剖靶点来增强当前的神经治疗方法，从而规避现代精神病疾病分类学和治疗中固有的许多限制。
Psychiatric conditions are common and often disabling. Although great strides have been made in alleviating symptoms with pharmacotherapy and psychotherapeutic approaches, many patients continue to have severe disease burden despite the best therapies available. One of the pervasive challenges to improving treatment is that present diagnostic and therapeutic strategies lag behind our modern conceptualization of the pathophysiology of these disorders. Psychiatric symptoms manifest through activity in specific neural circuits; thus, therapies capable of modulating these circuits are attractive. The investigators reviewed recent advances that facilitate treating medically refractory psychiatric disorders with intracranial neuromodulation in a way that intervenes more directly with the underlying pathophysiology. Specifically, they reviewed the prospects for using intracranial multielectrode arrays to record brain activity with high spatiotemporal resolution and identify circuit-level electrophysiological correlates of symptoms. A causal relationship of circuit electrophysiology to symptoms could then be established by modulating the circuits to disrupt the symptoms. Personalized therapeutic neuromodulation strategies can then proceed in a rational manner with stimulation protocols informed by the underlying circuit-based pathophysiology of the most bothersome symptoms. This strategy would enhance current methods in neurotherapeutics by identifying individualized anatomical targets with symptom-specific precision, circumventing many of the limitations inherent in modern psychiatric nosology and treatment.
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影响因子：
16.6
作者：
Ezzyat Y;Wanda PA;Levy DF;Kadel A;Aka A;Pedisich I;Sperling MR;Sharan AD;Lega BC;Burks A;Gross RE;Inman CS;Jobst BC;Gorenstein MA;Davis KA;Worrell GA;Kucewicz MT;Stein JM;Gorniak R;Das SR;Rizzuto DS;Kahana MJ
通讯作者：
Kahana MJ
影响因子：
3.5
作者：
Crowell AL;Garlow SJ;Riva-Posse P;Mayberg HS
通讯作者：
Mayberg HS
影响因子：
4.7
作者：
Holland, Marshall T.;Trapp, Nicholas T.;Greenlee, Jeremy D. W.
通讯作者：
Greenlee, Jeremy D. W.
影响因子：
25
作者：
Boyden, ES;Zhang, F;Deisseroth, K
通讯作者：
Deisseroth, K
DOI：
10.1109/tnsre.2017.2677443
发表时间：
2017-10
期刊：
IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society
影响因子：
--
作者：
Brandman DM;Cash SS;Hochberg LR
通讯作者：
Hochberg LR