Deep brain stimulation: the spectrum of application
Notice bibliographique
Résumé
Brain stimulation of deep, subcortical structures developed with stereotactic surgery in the mid-20th century to treat various conditions including movement disorders and chronic pain. Chronic electrical stimulation eventually largely replaced radiofrequency lesioning because of its inherent safety and treatment versatility. Regardless of the site of stimulation, parameters can be adjusted to reduce side effects and optimize clinical outcomes. Deep brain stimulation (DBS) is now widely accepted as the primary treatment for movement disorders that are refractory to medical therapies—namely Parkinson disease, tremors, and dystonia. Recent clinical studies have suggested beneficial effects of DBS applied to other conditions such as depression,5,6 obsessive-compulsive disorder,2–4 and epilepsy.1 Several key factors have led to widespread interest in investigating the use of DBS as a new treatment for additional conditions. First, the relative safety of contemporary stereotactic surgery has resulted in more acceptance of DBS as a potential modality for patients in whom other treatment options are absent. Second, DBS is recognized by referring clinicians as a therapy that, unlike the lesioning procedures, is both reversible and adjustable. Third, an improved understanding of brain targets and their role in disease has become possible because of electrophysiological studies, high-resolution MR imaging, and functional imaging techniques. Thus, numerous diseases previously thought to have limited medical therapeutic options are now being considered as conditions potentially amenable to surgery and, specifically, brain stimulation. This current issue of Neurosurgical Focus examines the current state of DBS and explores the emerging applications in disorders other than Parkinson disease and tremor. The first section is devoted to setting the historical context and to the treatment of movement disorders. This includes uses of DBS in the pediatric population and the neurochemical effects of brain stimulation that can be measured with a new wireless device for near real-time detection. Professor Hariz provides a most thorough historical review of brain stimulation. Newer indications of DBS in the treatment of psychiatric disease and epilepsy are currently under active investigation, and several articles are included that expand the basis for the use of brain stimulation. Lipsman and colleagues address the ethical issues involved in clinical trials for psychiatric patients, and they provide “criteria” for the psychiatry and neurosurgery communities to consider as surgical therapies are advanced. In addition, this section covers some potentially interesting applications of DBS being investigated for such indications as cluster headache, impaired consciousness, and morbid obesity. This issue of Neurosurgical Focus serves as a modern, online chapter describing the current state of DBS and the next generation of disorders that may be successfully treated. (DOI: 10.3171/2010.8.FOCUS.Intro)
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».