深部脑刺激对神经精神疾病的治疗与未来展望

摘要

随着社会老龄化和日渐加深的心理压力等因素的影响,世界范围内包括帕金森症、肌张力失常、强迫症、抑郁症、癫痫等与神经回路异常相关的神经精神系统疾病患者的数量急剧增加,目前全球患者已逾五亿六千万人.深部脑刺激技术(DBS)已广泛成为治疗这些疾病的重要方法.尽管DBS的作用机制尚不完全明了,但由于其具有微损伤、可回复和可调节的优点,已成为一项可靠、有效的神经外科手术方法.文中对DBS装置、作用机制、疾病治疗和发展方向等方面进行阐述,同时简述了其他治疗方法(如经颅磁刺激),并对目前广泛应用于在体神经回路研究的光感基因神经调控技术(光遗传技术)对神经精神系统疾病的干预进行了展望.%With the population aging and effects of mental stress, a large population of patients (an estimated 560 million people worldwide) suffer from intractable neurological and psychiatric disorders with dysfunctional neural circuits, including Parkinsons disease, major depression, schizophrenia and many other diseases. Deep brain stimulation (DBS) is a therapeutic option for these diseases. Though the therapeutic mechanism of DBS is not fully understood because of the lacking cell specificity of the stimulation, it has become a reliable and effective technique of neurosurgery for its less invasiveness, reversibility and adjustability. In this review, we introduced the construction, possible function mechanisms and clinical applications of DBS. Besides of DBS, we also introduced another therapeutics option of transcranial magnetic stimulation (TMS) for these diseases.A cutting edge research tool of optogenetic technology, and its possible clinical application for neurological and psychiatric disorders,were presented as well.