Deep brain stimulation: foundations and future trends.
نویسندگان
چکیده
Deep brain stimulation (DBS) has emerged as a revolutionary treatment option for essential tremor (ET), Parkinson's disease (PD), idiopathic dystonia, and severe obsessive-compulsive disorder (OCD). This article reviews the historical foundations of DBS including basal ganglia pathophysiological models, classic principles of electrical stimulation, technical components of the DBS system, treatment risks, and future directions for DBS. Chronic high frequency stimulation induces a number of functional changes from fast physiological to slower metabolic effects and ultimately leads to structural reorganization of the brain, so-called neuroplasticity. Examples of each of these fast, slow, and long-term changes are given in the context of Parkinson's disease where these mechanisms have perhaps been the most intensely investigated. In particular, details of striatal dopamine release, expression of trophic factors, and a possible neuroprotective mechanism of DBS are highlighted. We close with a brief discussion of technical and clinical considerations for improvement. Deep brain stimulation will continue to offer a reversible and safe therapeutic option for a host of neurological conditions and remains one of the best windows into human brain physiology.
منابع مشابه
Closed- and Open-loop Deep Brain Stimulation: Methods, Challenges, Current and Future Aspects
Deep brain stimulation (DBS) is known as the most effective technique in the treatment of neurodegenerative diseases, especially Parkinson disease (PD) and epilepsy. Relative healing and effective control of disease symptoms are the most significant reasons for the tangible tendency in use and development of this technology. Nevertheless, more cellular and molecular investigations are required ...
متن کاملTreatment of Neurological and Psychiatric Disorders with Deep Brain Stimulation Raising Hopes and Future Challenges
The technology of Neural Stimulation in recent years has become the focus of the research and treatment, although it has been around for many years. The potential use of stimulating the brain and nerves ranges from the spinal cord stimulation to the implantations of cochlear and bionic eyes with a large discrepancy between the clinical readiness for these various uses. Electrical high-frequency...
متن کاملO10: Deep Brain Stimulation and Psychiatry
The use of deep brain stimulation in psychiatric disorders has received great interest owing to the small risk of the operation, the reversible nature of the technique, and the possibility of optimizing treatment postoperatively. Currently deep brain stimulation in psychiatry is investigated for obsessive-compulsive disorder, Gilles de la Tourette’s syndrome and major depression. This presentat...
متن کاملControl of epileptic seizures by electrical low frequency deep brain stimulation: A review of probable mechanisms
Epilepsy is the most common neurological disease with no definitive method in treatment. Notably, the main way to treat and control epileptic seizures is drug therapy. However, about 20-30% of patients with epilepsy are drug resistant and require other therapeutic manners. Deep brain stimulation is a new therapeutic strategy for these patients. Conspicuously, there are no clear answers for basi...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Frontiers in bioscience
دوره 23 شماره
صفحات -
تاریخ انتشار 2018