严重难治性强迫症和抑郁症:我们应该考虑立体神经外科手术吗?
1Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, London, UK.
Neuropsychiatric disease and treatment
|March 11, 2024
概括
功能性神经外科手术为强迫症和抑郁症等严重精神障碍提供了希望. 像深度大脑刺激等技术的进步提高了安全性和有效性,但转诊率仍然很低.
科学领域:
- 神经外科 神经外科
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
背景情况:
- 功能性神经外科手术有着一个长达一个世纪的历史,从治疗运动障碍发展到治疗神经精神疾病.
- 像强迫症和抑郁症这样的严重精神障碍越来越多地被理解为网络障碍,容易接受神经外科干预.
- 尽管有证据和技术进步,但耐药性精神障碍的患病率和患者转诊专用神经外科治疗之间的差距仍然很大.
研究的目的:
- 审查神经外科运动和精神障碍的历史发展.
- 突出神经外科技术的进步及其安全概况.
- 提出支持心理健康状况的功能神经外科手术的证据,并倡导加强合作.
主要方法:
- 对运动障碍的历史神经外科手术程序的审查.
- 检查现代立体技术:射频剥离,马刀,深度大脑刺激和MRI引导的聚焦超声波.
- 对功能神经外科手术在强迫症和抑郁症中的临床试验证据的分析.
主要成果:
- 对于运动障碍的神经外科手术程序已被确立为标准护理.
- 技术进步显著提高了功能神经外科手术的安全性.
- 一级证据支持某些神经外科干预对强迫症和抑郁症等耐药精神障碍的疗效.
结论:
- 功能性神经外科手术为患有严重,治疗阻断性精神障碍的患者提供了可行的治疗选择.
- 加强精神病学和神经外科之间的理解和合作对于弥合转诊差距至关重要.
- 现代功能性神经外科手术为患者群体提供了希望和改善的结果,患者群体的选择有限.
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