Sâu não kích thích (DBS) có cuộc cách mạng điều trị rối loạn chuyển động nhiều, đặc biệt là Parkinson bệnh (PD) (Krack et al, 2003.); Dystonia (Vidailhet et al, 2005.); Và run (. Schuurman et al, 2000) . Ngoài ra, nó đã được ủng hộ cho các điều kiện khác nhau như | 2 Cellular Mechanisms of Action of Therapeutic Brain Stimulation Introduction. 2-1 Zelma Kiss and Trent Anderson DBS for Essential Tremor. 2-1 Mechanisms of Action. 2-3 Local Effects of DBS Distant Effects of DBS Comparison of Slice Experiments in Thalamus and STN Summary and Functional Implications Potential of DBS Therapy. 2-15 References. 2-16 Introduction Deep brain stimulation DBS has revolutionized the treatment of several movement disorders notably Parkinson s disease PD Krack et al. 2003 dystonia Vidailhet et al. 2005 and tremor Schuurman et al. 2000 . In addition it has been advocated for other conditions as diverse as obsessive-compulsive disorder Nuttin et al. 2003 depression Mayberg et al. 2005 epilepsy Kerrigan et al. 2004 Theodore and Fisher 2004 pain Kumar et al. 1997 cluster headache Schoenen et al. 2005 Leone et al. 2001 and even obesity Benabid et al. 2005 . Although the site of electrode implantation varies depending on the condition the common feature of all DBS therapy is that the electrical pulses must be high frequency 100 Hz to be effective. Exactly how DBS works and its effects on neuronal functioning within the stimulated nucleus and downstream structures are the focus of this chapter. This chapter briefly reviews the clinical use of DBS in thalamus for the treatment of tremor to illustrate some of the fundamental effects of DBS that must be explained by cellular models. Most of the chapter is devoted to the proposed mechanisms of action of DBS and the author s investigations of the underlying cellular effects. The similarities and differences in cellular effects of DBS in thalamus are compared to similar in vitro studies in subthalamic nucleus STN . Finally the potential of therapeutic electrical stimulation is discussed based on our present understanding of its mechanisms of action. DBS for Essential Tremor Essential tremor ET is a common movement disorder in which patients exhibit a postural or action-induced 3-
