脳深部刺激療法 (DBS)

• 深谷 親

  日本大学附属病院ニューロモデュレーションセンター 日本大学医学部応用システム神経科学・脳神経外科

• 小林 一太

  日本大学附属病院ニューロモデュレーションセンター 日本大学医学部応用システム神経科学・脳神経外科

• 大島 秀規

  日本大学附属病院ニューロモデュレーションセンター 日本大学医学部応用システム神経科学・脳神経外科

• 山本 隆充

  日本大学附属病院ニューロモデュレーションセンター 日本大学医学部応用システム神経科学・脳神経外科

• 片山 容一

  日本大学附属病院ニューロモデュレーションセンター 日本大学医学部応用システム神経科学・脳神経外科

書誌事項

タイトル別名

• Deep Brain Stimulation

抄録

Deep brain stimulation (DBS) is an important component of the therapy for movement disorders and intractable pain. In Japan, the first case of DBS for controlling central pain syndrome was experienced in 1979 and DBS of the thalamic nucleus ventralis caudalis and periaqueductal gray matter have been used for pain control for many years. Neurosurgeons also initiated a clinical trial of DBS for controlling movement disorders, such as tremor, Parkinson′s disease (PD) and dystonia. Our government approved DBS to be covered by the public insurance system for pain control in 1992 and for movement disorders in 2000. In particular, DBS for subthalamic nucleus (STN) is currently the most common therapeutic surgical procedure for patients with PD. The long-lasting beneficial effects of STN-DBS on motor function have now largely been acknowledged. However, behavioral and/or psychiatric changes have been demonstrated in certain case reports and case series. DBS is also a successful therapeutic option for patients with primary dystonia and tremor syndrome who do not respond sufficiently to conservative therapies. The most common target of DBS in patients with dystonia is the internal region of the globus pallidus (GPi). GPi-DBS leads to long-lasting and remarkable improvement of dystonic movements in majority of patients. In Parkinson′s tremor or post-stroke movement disorder, the intermediate ventral nucleus of the thalamus (Vim) and the subthalamic region have proven to be promising targets for DBS electrodes. Especially in patients with essential tremor, Vim-DBS leads to an acute reduction of the tremor. In addition, DBS is beginning to be used as a new therapeutic procedure for psychiatric diseases, such as depression and obsessive-compulsive neurosis in many countries. We will summarize our experiences and previous reports, and discuss the mechanism and future perspectives for DBS in the management of central nervous system disorders.

収録刊行物

• 日大医学雑誌

  日大医学雑誌 70 (3), 162-166, 2011

  日本大学医学会

キーワード

• 不随意運動
• 難治性疼痛
• 大脳基底核
• 視床

詳細情報

• CRID: 1390282681408669056
• NII論文ID: 130004548874
• DOI: 10.4264/numa.70.162
• ISSN: 18840779
• ISSN: 00290424
• Web Site: https://www.jstage.jst.go.jp/article/numa/70/3/70_3_162/_pdf
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可