中国实用儿科杂志

中国实用儿科杂志 ›› 2025, Vol. 40 ›› Issue (4): 314-319.DOI: 10.19538/j.ek2025040609

• 专题笔谈 • 上一篇    下一篇

儿童抽动障碍的神经调控治疗

  

  1. 首都医科大学附属北京儿童医院功能神经外科，北京  100045
  • 出版日期:2025-04-06 发布日期:2025-05-13
  • 通讯作者: 梁树立，电子信箱：301_1sjwk@sina.cn

Neuromodulation therapy for children with tic disorders

  1. Functional Neurosurgery Department，Beijing Children’s Hospital，Capital Medical University，Beijing  100045，China
  • Online:2025-04-06 Published:2025-05-13

摘要： 抽动障碍（TD）是以抽动为主要表现的神经发育障碍性疾病，其病因和致病机制不明，可能与遗传因素、神经心理因素和环境因素等有关。TD与复杂神经网络紊乱有关，特别是皮质-基底节-丘脑-皮质回路失调。目前TD治疗主要包括行为治疗、药物治疗和神经调控治疗等方面。神经调控治疗包括脑深部电刺激术（DBS）、重复经颅磁刺激术和迷走神经刺激术。近年来，很多临床研究发现神经调控治疗在抽动症状方面也存在较好疗效，尤其是DBS。文章重点就DBS治疗的历史、作用机制、方法、目标、手术年龄和效果等方面进行了总结，为临床提供参考。

关键词: 抽动障碍, 神经调控, 脑深部电刺激术, 脑网络

Abstract: Tic disorders （TD） are neurodevelopmental disor-ders characterized primarily by tics. The etiology and pathogenesis of TD are unknown and may be related to genetic， neuropsychological and environmental factors. TD is associated with the disorder of complex brain networks， particularly the dysregulation of the cortical- basal ganglia-thalamic-cortical circuit. At present， the treatment for TD mainly includes three aspects： behavioral therapy， drug therapy， and neuromodulation therapy. Neuromodulation therapy includes deep brain stimulation （DBS）， repetitive transcranial magnetic stimulation， and vagus nerve stimulation. In recent years， many clinical studies have found that neuromodulation also has promising therapeutic outcomes in the treatment of tic symptoms， especially DBS. This article focuses on summarizing the history， mechanism of action， surgical approach， goals of treatment， age at surgery and efficacy of DBS in childrenwith TD，which providesreference for clinical practice.

Key words: tic disorders, neuromodulation, deep brain stimulation, brain network