Thalamic Deep Brain Stimulation for Parkinson’s Disease

Thalamic Deep Brain Stimulation for Parkinson’s Disease
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丘脑深部脑刺激治疗帕金森病

DOI:
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发表时间:
2011
期刊:
影响因子:
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通讯作者:
Satoshi Goto
Satoshi Goto
中科院分区:
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文献类型:
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作者:
R. Morigaki;Shinji Nagahiro;Ryuji Kaji;Satoshi Goto

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随着神经影像学和神经外科技术的最新进展,以及对脑功能运动回路的更好理解,越来越多的证据表明,脑深部电刺激(DBS)可以成为医学上难治性运动障碍和神经精神疾病的一种强大而安全的治疗选择。半个多世纪以来,丘脑腹外侧核(VL)一直是立体定向手术(例如,消融手术和DBS)治疗各种类型震颤的解剖靶点,包括帕金森病(PD)相关震颤。VL核包括中间腹侧核(Vim)和口腹侧核(Vo) (Hassler, 1959)。目前,丘脑DBS因其可逆性、可调节性、低侵入性等优点被广泛应用。丘脑深部电刺激能有效缓解帕金森震颤;然而,除了震颤之外,它并不能持续改善帕金森病的症状。因此,它的使用仅限于震颤型PD患者,在这些患者中,其他运动症状没有致残。在这篇综述中,我们将调查丘脑DBS治疗帕金森病的基本原理和目前的应用。
With recent advances in neuroimaging and neurosurgical techniques as well as better understanding of functional motor brain circuits, there is increasing evidence that electrical deep brain stimulation (DBS) can be a powerful and safe therapeutic option for medically intractable movement disorders and neuropsychiatric diseases. For more than half a century, the ventrolateral (VL) nucleus of the thalamus has been an anatomical target for stereotactic surgeries (e.g., ablation surgery and DBS) treating various types of tremors, including Parkinson’s disease (PD)-associated tremor. The VL nucleus comprises the nucleus ventralis intermedius (Vim) and the nucleus ventralis oralis (Vo) (Hassler, 1959). Currently, thalamic DBS is widely used because of its reversibility, adjustability, and low level of invasiveness. Thalamic DBS of the Vim nucleus can effectively alleviate parkinsonian tremor; however, it does not provide consistent improvement in parkinsonian symptoms other than tremor. Therefore, its use is limited to patients with tremorpredominant PD, in whom other motor symptoms are not disabling. In this review, we will survey the rationale and current use of thalamic DBS in the treatment of PD.
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