Mechanisms of deep brain stimulation
Mechanisms of deep brain stimulation
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DOI：
10.1002/mds.10145
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发表时间：
2002-01-01
影响因子：
8.6
通讯作者：
Pollak, P
中科院分区：
文献类型：
--
作者：
Benabid, AL;Benazzous, A;Pollak, P
高频脑深部电刺激的作用机制仍不清楚。然而，在所有情况下，在迄今为止刺激的所有靶核中，效应模拟了先前在丘脑切开术、苍白球切开术或甚至丘脑底核切开术期间造成的损伤，表明如果不是靶本身，至少抑制了包含靶的神经元网络。相反，纤维束在低或高频率下始终被激活。因此，设想的假设机制应该是兼容的，甚至产生这些观察到的效应，才能作为假设被接受。这一机制可能是一个原因，也可能是几个原因的组合：反馈回路的阻塞、包含在更复杂网络中的抑制性结构的激活、膜离子通道的阻断、去极化阻断、突触耗竭、早期基因的诱导、局部血流的变化、神经可塑性等。可能一些与急性效应有关，而另一些与长期变化有关，接近神经可塑性。很明显，对这种奇怪而强大的现象的理解将受益于临床观察和精心设计的动物实验。(C)2002运动障碍协会。
The mechanism of action of high frequency deep brain stimulation is still unknown. However, in all circumstances and in all target nuclei so far stimulated, the effects mimic those of lesions previously made during thalamotomies, pallidotomies or even subthalamotomies, suggesting an inhibition of at least the neuronal network containing the target, if not of the target itself. On the contrary, fiber bundles are consistently activated at low or high frequencies. The hypothetical mechanisms envisioned should therefore be compatible and even produce these observed effects, to be acceptable as hypotheses. The mechanism could be either one or a combination of several causes: jamming of a feedback loop, activation of inhibitory structures included in a more complex network, blockade of membrane ion channels, deplorisation blockade, synaptic exhaustion, induction of early genes, changes in local blood flow, neuroplasticity, etc. It is probable that some are more involved in the acute effects and others in the long term changes, close to neuroplasticity. It is clear that the understanding of this strange and powerful phenomenon will profit from both clinical observation and well designed animal experiments. (C) 2002 Movement Disorder Society.