什么是深脑刺激？

Deep brain stimulation (DBS) has been shown to be a viable option for some people who have depression. Doctors originally used it to help manage Parkinson’s disease. In DBS, a doctor implants tiny electrodes in the part of the brain that regulates mood. Some doctors have practiced DBS since the 1980s, but it’s a rare procedure. Although long-term success rates have yet to be established, some doctors recommend DBS as an alternative therapy for patients whose previous depression treatments have been unsuccessful.

医生手术上植入细胞核宫内的微小电极，这是脑的区域负责：

  • dopamine and serotonin release
  • 动机
  • 情绪

The procedure requires multiple steps. First, the doctor places the electrodes. Then, a few days later they implant the wires and battery pack. The electrodes are connected via wires to a pacemaker-like device implanted in the chest that delivers pulses of electricity to the brain. The pulses, which are generally delivered constantly appear to block the firing of neurons and return the brain’s metabolism back to a state of equilibrium. The pacemaker can be programmed and controlled from outside the body by a handheld device.

虽然医生不确定为什么脉冲有助于大脑重置，但治疗似乎改善了情绪，并给人一个整体的平静感。

In many DBS clinical trials, people have reported alleviation of their depression and a significant increase in quality of life. In addition to depression, doctors use DBS to treat people with:

  • obsessive-compulsive disorder
  • Parkinson’s disease and dystonia
  • 焦虑
  • epilepsy
  • high blood pressure

DBS是慢性或治疗抗抑郁症的人的选择。在考虑DB之前，医生建议延长的心理治疗和药物治疗疗法，因为它涉及侵入性外科手术和成功率不同。年龄通常不是问题，但医生建议你掌握足够的健康，以承受一部主要的手术。

DBS通常被认为是安全的程序。然而，与任何类型的脑手术一样，并发症总是可能出现。与DB相关的常见并发症包括：

  • a brain hemorrhage
  • a stroke
  • 感染
  • 头痛
  • speech problems
  • sensory or motor control issues

需要考虑的另一个因素是需要随后的手术。胸部植入的监控装置可以破裂，它的电池持续六到18个月。如果处理似乎没有工作，则需要调节植入电极。您需要考虑是否足够健康以进行第二次或第三部手术。

由于长期研究和临床试验显示DBS的不同结果，医生只能指向自己的成功或失败。Joseph J. Fins博士，纽约 - 长老康奈尔中心医院/威尔康尔康奈尔中心医疗伦理主任表示，使用DBS的心理和情绪条件应“在它被称为治疗之前充分测试”。

Other experts think DBS is a viable option for people who aren’t seeing success with other therapies. Dr. Ali R. Rezai of the Cleveland Clinic notes that DBS “holds promise for the treatment of intractable major depression.”

DBS是一种具有不同结果的侵入性外科手术。医疗领域混合了评论和意见。大多数医生同意的一件事是DBS应该是治疗抑郁症的远方选择，并且人们应该在选择手术之前探索药物和心理治疗。如果您认为DBS可能是您的选择，请与您的医生交谈。