For many decades, psychiatric treatment has been primarily guided by two major paradigms of psychopathology: a neurochemical paradigm leading to the development of medications and a psychological paradigm resulting in the development of psychotherapies. A third paradigm positing that psychiatric dysfunction results from abnormal communication within a network of brain regions that regulate mood, thought, and behavior has gained increased attention over the past several years and underlies the development of multiple neuromodulation and neurostimulation therapies. This neural circuit paradigm is not new. In the late 19th and early 20th centuries, it was a common way of understanding psychiatric illness and led to several of our earliest somatic therapies. However, with the rise of effective medications and evidence-based psychotherapies, this paradigm went mostly dormant. Its recent reemergence resulted from a growing recognition that medications and psychotherapy leave many patients inadequately treated, along with technological advances that have revolutionized our ability to understand and modulate the neural circuitry involved in psychiatric disorders. In this overview, the authors review the history and current state of neuromodulation for psychiatric illness and specifically focus on these approaches as a treatment for depression, as this has been the primary indication for these interventions over time.

几十年来，精神病治疗主要由两种主要的精神病理学范式指导：导致药物发展的神经化学范式和导致心理治疗发展的心理范式。假设精神功能障碍是由调节情绪、思想和行为的大脑区域网络内的异常交流引起的第三种范式在过去几年中受到越来越多的关注，并成为多种神经调节和神经刺激疗法发展的基础。这种神经回路范式并不新鲜。在 19 世纪末和 20 世纪初，它是理解精神疾病的一种常见方式，并导致了我们最早的几种躯体疗法。然而，随着有效药物和循证心理疗法的兴起，这种范式大多处于休眠状态。它最近的重新出现是由于人们越来越认识到药物和心理治疗使许多患者得不到充分治疗，以及技术进步彻底改变了我们理解和调节涉及精神疾病的神经回路的能力。在这篇概述中，作者回顾了精神疾病神经调节的历史和现状，并特别关注这些方法作为抑郁症的治疗方法，因为随着时间的推移，这一直是这些干预措施的主要适应症。随着技术进步彻底改变了我们理解和调节涉及精神疾病的神经回路的能力。在这篇概述中，作者回顾了精神疾病神经调节的历史和现状，并特别关注这些方法作为抑郁症的治疗方法，因为随着时间的推移，这一直是这些干预措施的主要适应症。随着技术进步彻底改变了我们理解和调节涉及精神疾病的神经回路的能力。在这篇概述中，作者回顾了精神疾病神经调节的历史和现状，并特别关注这些方法作为抑郁症的治疗方法，因为随着时间的推移，这一直是这些干预措施的主要适应症。