【摘要】 深部脑刺激(DBS)是目前治疗运动障碍疾病的一种有效手段,也是探索神经回路功能的一个常用工具。尽管DBS的临床疗效已经得到了充分证实,但因其作用机制尚不完全清楚,限制了该技术的进一步研发、优化与应用。电生理实验和建模仿真研究显示,DBS优先激活电极附近的轴突和突触前末梢,所产生的轴突放电通过引起逆向激活、顺向激活和神经递质释放,进而刺激靶细胞的胞体和树突以及靶细胞的上游和下游核团。靶向核团内部纤维的复杂分枝结构使得逆向激活成为DBS影响脑内多个解剖区域的一个重要细胞机制。特别地,逆向激活可以用来理解刺激诱发的多种微观、介观和宏观效应。首先归纳总结了DBS在细胞层次的基本作用规律,重点介绍了刺激的逆向激活效应,然后综述了近年来关于逆向激活模式的研究成果,并在此基础上讨论了逆向激活对理解DBS效应的重要意义,最后对逆向激活研究进行了展望。更多还原

【Abstract】 Deep brain stimulation (DBS) is an effective treatment for movement disorders,which is also a common tool for probing the function of neural circuits. Although the therapeutic efficacy of DBS has already been demonstrated in clinics,the precise mechanisms of its action still remain largely unclear,which limits the further development,optimization,and application of this technology. Electrophysiological experiments and computational models indicate DBS preferentially activates the axons and presynaptic terminals, and the resulting axonal spikes stimulate the cell body and dendrites of target cells as well as the upstream and downstream nuclei through inducing antidromic activation,orthodromic activation,and neurotransmitter release.The fibers projecting to the target nuclei exhibit complex branching structures,which enables the antidromic activation to be an important cellular mechanism underlying the widespread effects of DBS on multiple anatomical structures. Particularly,antidromic activation contributes to the understanding of microscopic,mesoscopic,and macroscopic effects of DBS. In this paper,we first summarized the general cellular principles of action of DBS,and mainly introduced the stimulus-induced antidromic activation. Then,we presented an exhaustive review on the main findings of antidromic activation pattern in recent years,and discussed the implications of antidromic activation for understanding the effects of DBS. Finally,we raised several key issues on the antidromic activation that need to be addressed in the future.更多还原