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Dianas quirúrgicas en el tratamiento de enfermedades psiquiátricas: Desde el movimiento a las emociones

机译:精神疾病的外科手术目标:从运动到情绪

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Deep brain stimulation (DBS) for psychiatric disorders refractory to conventional treatments are currently been performed based in the knowledgment obtained in the motor disorder surgery and mainly in Parkinson's disease. Depression, obsessive-compulsive disorder (OCD) and Tourette syndrome, all of them are cortico-striato-thalamo-cortical pathological process involved in the limbic loop of the basal ganglia. This review describes the different targets in these pathological neuro-psychiatric disorders. For OCD there are currently two targets, ventral striatum (VS) Accumbens nucleus (Nacc) and the subthalamic nucleus (STN). In refractory depression the subgenual area (25 Brodmann area) and VS/Nacc. For Tourette syndrome the ventralis oralis internus and centromedianum/parafascicularis of the thalamus (Voi and CM/Pf) and the internal part of the globus pallidus (GPi). Currently there are no specific surgical target for each pathological disorder because clinical results reported are very similar after stimulation surgery. In other point, a selected surgical target also may improve different pathologies.
机译:目前基于运动障碍手术中获得的知识(主要是帕金森氏病)进行针对传统治疗难治的精神疾病的深层脑刺激(DBS)。抑郁症,强迫症(OCD)和图雷特综合征(Tourette syndrome),都是与基底神经节边缘环有关的皮质-纹状体-丘脑-皮质皮质病理过程。这篇综述描述了这些病理性神经精神疾病的不同靶标。对于强迫症,目前有两个目标,腹侧纹状体(VS)伏隔核(Nacc)和丘脑下核(STN)。在难治性抑郁症中,属下部位(25 Brodmann部位)和VS / Nacc。对于图雷特综合症,丘脑的腹侧腹腔和中央腹膜/筋膜旁旁(Voi和CM / Pf)以及苍白球的内部(GPi)。当前没有针对每种病理疾病的特异性手术靶标,因为报道的临床结果在刺激手术后非常相似。另一方面,选定的手术目标也可以改善不同的病理状况。

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