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quinidine木虫 (著名写手)
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Abstract 1: We considered clinical observations in patients with obsessive-compulsive- and anxiety-disorders, who underwent bilateral anterior capsulotomy, as well as anatomical and pathophysiological findings. Based on these considerations, we choose the shell region of the right nucleus accumbens as target for deep brain stimulation (DBS) in a pilot-series of four patients with severe obsessive-compulsive- and anxiety-disorders. Significant reduction in severity of symptoms has been achieved in three of four patients treated. Clinical results as well as a 15-O-H(2)O-PET study, perfomed in one patient during stimulation, speak in favour of the following hypothesis. As a central relay-structure between amygdala, basal ganglia, mesolimbic dopaminergic areas, mediodorsal thalamus and prefrontal cortex, the accumbens nucleus seems to play a modulatory role in information flow from the amygdaloid complex to the latter areas. If disturbed, imbalanced information flow from the amygdaloid complex could yield obsessive-compulsive- and anxiety-disorders, which can be counteracted by blocking the information flow within the shell region of the accumbens nucleus by deep brain stimulation. Abstract 2: OBJECTIVE: To describe smiling and euphoria induced by deep brain stimulation (DBS). BACKGROUND AND SIGNIFICANCE: The brain systems inducing emotional experiences and displays are not entirely known, but the ventral striatum including the nucleus accumbens has been posited to play a critical role in mediating emotions with positive valence. DBS has been successfully employed for the treatment of movement disorders, and most recently obsessive compulsive disorder (OCD). The purpose of this report is to describe the emotional changes associated with stimulation of the ventral striatum. METHODS: A single patient with intractable OCD had electrode arrays placed in the right and left anterior limbs of the internal capsule and region of the nucleus accumbens. Changes in facial movement during stimulation were quantified by video recording. Ten video segments, time locked to the onset of stimulation, were digitized and changes in pixel intensity that occurred over both sides of the lower face, on a frame by frame basis, following stimulation onset were computed. These summed changes in pixel intensity represented the dependent variable of "entropy" and directly corresponded to changes in light reflectance that occur during facial movement. RESULTS: During stimulation on both the right and left side, the patient consistently developed a half smile on the side of the face contralateral to the stimulating electrode, and also became euphoric. The effect ceased when DBS was discontinued. CONCLUSIONS: DBS in the region of the nucleus accumbens produced smile and euphoria suggesting that alterations in the ventral striatum may result in emotional experience and displays. We hypothesize the existence of a limbic-motor network responsible for such changes. This observation suggests that DBS may be useful as a therapy for mood disorders. |
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至尊木虫 (知名作家)
Translator and Proofreader
- 翻译EPI: 1690
- 应助: 452 (硕士)
- 金币: 31580.9
- 红花: 100
- 帖子: 7681
- 在线: 19966.6小时
- 虫号: 3328089
- 注册: 2014-07-17
- 专业: 肿瘤发生
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quinidine: 金币+40, 翻译EPI+1, ★★★★★最佳答案, 翻的真好，太感谢了！ 2014-09-08 16:48:20
quinidine: 金币+40, 翻译EPI+1, ★★★★★最佳答案, 翻的真好，太感谢了！ 2014-09-08 16:48:20
| 摘要1：我们评估了接受双侧内囊前肢切开术的强迫症（OCD）和焦虑症患者的临床观察，以及解剖和病理生理的研究结果。根据这些评估，我们选择了右侧伏隔核的外壳区作为靶位，进行深部脑刺激（DBS），对四例患有严重OCD和焦虑症患者进行了实验性治疗。在四例病人中，三例出现症状明显减轻。在刺激治疗期间，一个病人的临床结果以及15-O-H(2)O-PET（正电子发射断层扫描）研究都支持下列假说：作为杏仁核、基底核、中脑边缘多巴胺区域、中背侧丘脑和额叶皮质之间的中继结构，伏隔核可能在从杏仁复合体到后面诸脑区信息传递中发挥调节作用。如果受到干扰，从杏仁复合体传出的不平衡信息可能会造成OCD和焦虑症，而在伏隔核之外壳区用DBS阻断这一（不平衡）信息的传递可以对抗OCD和焦虑症。 |
2楼2014-09-08 10:45:03
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至尊木虫 (知名作家)
Translator and Proofreader
- 翻译EPI: 1690
- 应助: 452 (硕士)
- 金币: 31580.9
- 红花: 100
- 帖子: 7681
- 在线: 19966.6小时
- 虫号: 3328089
- 注册: 2014-07-17
- 专业: 肿瘤发生
【答案】应助回帖
★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★
quinidine: 金币+40, ★★★★★最佳答案, 谢谢 2014-09-08 16:48:30
quinidine: 金币+40, ★★★★★最佳答案, 谢谢 2014-09-08 16:48:30
| 摘要2：目的：描述深部脑刺激（DBS）引起的微笑和欣快。背景与意义：大脑系统诱发的情感体验和表现尚不完全清楚，但包括伏隔核在内的腹侧纹状体一直被认为在介导情绪与正面内在吸引了中发挥至关重要的作用。 DBS不仅已被成功用于对运动障碍的治疗，最近也被用于OCD的治疗。本报告的目的是描述刺激腹侧纹状体引起的有关情绪变化。方法：难治性OCD患者一例，将一电极阵列置于内囊前肢的右侧和左侧，以及伏隔核区域。刺激过程中面部运动用录影进行量化。对锁定于刺激开始的十个视频片段进行数字化处理，从刺激开始，逐帧计算两侧面部下半部分像素强度的变化情况。这些像素强度变化的相加代表“熵”的因变量，并直接对应于面部运动过程中发生的光反射率的变化情况。结果：在同时刺激右侧和左侧时，患者持续出现刺激电极对侧面部的微笑，并变为欣快。停止DBS时这种效果就停止了。结论：刺激伏隔区域引起笑容和欣快，表明腹侧纹状体的改变可能会导致情感体验和各种表现。我们的假设是，存在一种边缘-运动网络负责这种变化。这一观察表明，作为一种情绪障碍的治疗手段，DBS可能是有用的。 |
3楼2014-09-08 11:39:48
