外2016儿童神经调节成熟。

Perspective Pediatric Neuromodulation Comes of Age Paul E. Croarkin, DO, MSCS 1 and Alexander Rotenberg, MD, PhD 2 Abstract This special issue surveys recent work and underscores the challenges of psychiatric brain stimulation research with child and adolescent populations. The field of child and adolescent psychopharmacology is replete with examples of potential pitfalls in the assumption that ‘‘children are little adults.’’ Arguably, younger age portends more neurobiological and descriptive heterogeneity in research pursuits and clinical practice. For existing brain stimulation modalities, there are a paucity of translational models to design studies for youth and no well-studied dosing schemes. The long-term positive and negative effects of neuromodulation interventions in youth are unknown. Inherent pragmatic and ethical limitations often present barriers for participant recruitment and will necessitate innovative approaches to study design and team efforts. These challenges are not insurmountable, and sustained efforts will advance the growing field of pediatric neuromodulation. N euromodulation is arapidly evolving field that recognizes electricity as the primary currency of the brain. Collectively, neuromodulation includes a wide range of modalities such as transcranial direct current stimulation (tDCS), transcranial mag- netic stimulation (TMS), vagal nerve stimulation, electroconvulsive therapy (ECT), magnetic seizure therapy (MST), and deep brain stimulation (George and Aston-Jones 2010). Treatments stimulating relevant neurocircuitry in psychiatric disorders present unique re- search opportunities and much needed therapeutic advances for pa- tients with limited options (McClelland et al. 2016). Advances in brain stimulation have already changed the practice of psychiatry and composition of multidisciplinary treatment teams. For example, TMS is no longer considered investigational in adult major depres- sive disorder and has increasing accessibility (Dunner e