摘要： 脑深部电刺激术作为一种可逆、可调节的神经调控技术，已从最初用于治疗运动障碍疾病逐步拓展至精神疾病。本文综述其在难治性强迫症、难治性抑郁症、神经性厌食、物质使用障碍及难治性精神分裂症中的应用进展，脑深部电刺激术通过调节异常神经回路（如皮质-纹状体-丘脑-皮质回路、奖赏系统等）显著缓解症状，尤其在难治性强迫症中显示出较高的临床反应率和缓解率，然而仍面临刺激靶点选择个体差异大、缺乏生物学标志物、长期安全性及伦理问题等挑战。未来借助闭环反馈、纤维束追踪和精准医疗策略，推动脑深部电刺激术从试验性治疗向临床常规应用的转化。

关键词: 强迫性人格障碍, 抑郁症,难治性, 神经性厌食, 物质相关性障碍, 精神分裂症, 深部脑刺激法, 综述

Abstract: Deep brain stimulation (DBS), a reversible and adjustable neuromodulation technique, has expanded from its initial application in movement disorders to the treatment of mental disease. This review systematically summarizes the current applications and research progress of DBS in treatment-resistant obsessive-compulsive disorder (TR-OCD), treatment-resistant depression (TRD), anorexia nervosa (AN), substance use disorder (SUD), and treatment-resistant schizophrenia (TRS). Evidence indicates that DBS modulates dysfunctional neural circuits [e. g., cortito-striato-thalamo-cortical (CSTC) loop, reward system] and significantly alleviates symptoms, particularly showing high response and remission rates in TR- OCD. However, challenges remain, including interindividual variability in target selection, lack of predictive biomarkers, long-term safety concerns, and ethical issues. Future directions involve closed-loop stimulation, tractography-based targeting, and personalized medicine approaches to facilitate the transition of DBS from experimental therapy to clinical practice.

Key words: Compulsive personality disorder, Depressive disorder, treatment-resistant, Anorexia nervosa, Substance-related disorders, Schizophrenia, Deep brain stimulation, Review

中图分类号: 

• R741

• R651