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首页> 美国卫生研究院文献>Frontiers in Integrative Neuroscience >Industrial Perspective on Deep Brain Stimulation: History Current State and Future Developments
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Industrial Perspective on Deep Brain Stimulation: History Current State and Future Developments

机译：关于深部脑刺激的工业观点：历史现状和未来发展

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Deep brain stimulation (DBS) emerged in the late 1960s as a possible therapeutic alternative to lesioning in patients with severe, chronic, intractable pain. DBS devices in the era were based on cardiac pacing technology but were greatly modified in implementation due to the unique needs of DBS. Clinical studies in the 1970s and early 1980s have revealed a technique with modest results which did not lead to regulatory approval for the treatment of pain. In the 1980s a new application for DBS emerged in the treatment of movement disorders. Clinical trials confirmed the robustness of the therapy leading to approvals by regulatory authorities in the US and Europe for the treatment of tremor and the symptoms of Parkinson’s disease. Technology based on that used for earlier clinical research in pain was improved by leveraging advances in cardiac pacing technology resulting in the sophisticated and reliable systems available today. In the 1990s scientific exploration began in the treatment of psychiatric disorders which is ongoing today. Simultaneously, studies into the treatment of epilepsy were begun which resulted in regulatory approval in Europe. Suggestions have been made to expand these scientific explorations to other central nervous system dysfunctions. Opportunity remains to improve the technology including individualized and symptom specific stimulation patterns, more physician and patient friendly programming, and possibly closed-loop systems for more situation dependent and effective therapy.
机译：1960年代末期出现了深部脑刺激（DBS），它可作为重度，慢性，顽固性疼痛患者病变的一种可能的治疗选择。那个时代的DBS设备基于心脏起搏技术，但由于DBS的独特需求，在实现上进行了很大的修改。 1970年代和1980年代初期的临床研究表明，该技术的效果不明显，并未获得监管机构的批准以治疗疼痛。在1980年代，DBS在运动障碍的治疗中出现了新的应用。临床试验证实了该疗法的坚固性，并因此获得了美国和欧洲监管机构的批准，用于治疗震颤和帕金森氏病的症状。通过利用心脏起搏技术的进步，改进了基于早期疼痛临床研究的技术，从而形成了当今可用的复杂而可靠的系统。在1990年代，对精神疾病的治疗开始了科学探索，如今这一过程正在进行中。同时，开始了对癫痫治疗的研究，这导致了欧洲监管机构的批准。已经提出了将这些科学探索扩展到其他中枢神经系统功能障碍的建议。仍需要改进技术的机会，包括个性化的和特定症状的刺激方式，更多的医师和患者友好的程序以及可能采用闭环系统进行更多情况依赖和有效治疗的技术。

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