DBS in tourette syndrome: rationale, current status and future prospects.
DBS in tourette syndrome: rationale, current status and future prospects.
复制标题
DBS 治疗抽动秽语综合症：基本原理、现状和未来前景。
DOI：
10.1007/978-3-211-33081-4_24
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
V. Visser
中科院分区：
文献类型：
--
作者：
V. Visser
抽动秽语综合征是一种神经精神疾病，发病于儿童早期，以抽动为特征，常伴有行为异常。症状通常在成年前或成年期间消失。治疗包括心理治疗或药物治疗。一小部分患者是治疗难治性的。在1999年引入丘脑深部脑刺激（DBS）作为一种新的治疗方法后，少数患者的其他几个脑核团也被靶向，如苍白球内侧、前内侧和腹后外侧部分以及丘脑核。在已发表的报告中，描述了至少66%的抽搐减少率。DBS对相关行为障碍的影响更多变。接受治疗的患者数量很少，目前还不清楚DBS的效果是否取决于靶核。抽动秽语综合征的病理生理机制还不清楚。根据我们目前对皮质-基底节-丘脑皮质回路的了解，提出了DBS对抽搐的有益作用的解释。它的结论是，一个细致的电极位置的评价，并对抽搐和行为障碍的临床效果的盲法评估，是绝对强制性的，以确定最佳目标的DBS抽动秽语综合征。
Tourette syndrome is a neuropsychiatric disorder with onset in early childhood and characterized by tics, often associated with behavioural abnormalities. Symptoms often disappear before or during adulthood. Treatment consists of psychotherapy or pharmacotherapy. A small percentage of patients is treatment refractory. After the introduction of deep brain stimulation (DBS) of the thalamus as a new therapeutical approach in 1999, several other brain nuclei have been targeted in a small number of patients, like the globus pallidus internus, anteromedial and ventroposterolateral part, and the nucleus accumbens. In the published reports, a tic reduction rate of at least 66% is described. The effects of DBS on associated behavioural disorders are more variable. The number of treated patients is small and it is unclear whether the effects of DBS are dependent on the target nucleus. The pathophysiology of Tourette syndrome is not well understood. On the basis of our current knowledge of cortico-basal ganglia-thalamocortical circuits, an explanation for the beneficial effects of DBS on tics is proposed. It is concluded that a meticulous evaluation of the electrode position, and a blinded assessment of the clinical effects on tics and behavioural disorders, is absolutely mandatory in order to identify the best target of DBS for Tourette syndrome.
影响因子：
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作者：
Peterson, BS;Thomas, P;Staib, L
通讯作者：
Staib, L
影响因子：
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作者：
Peterson, BS;Skudlarski, P;Gore, JC
通讯作者：
Gore, JC