神经刺激和心率变化:对体性振荡信号的范围审查
Caitlin R Wessel1, Cemal Karakas2, Zulfi Haneef3
1University of Louisville School of Medicine, Louisville KY 40202, USA.
概括
对于耐药性 (DRE) 的神经刺激器 (VNS) 治疗不需要使心率变化 (HRV) 正常化以缓解. 在VNS植入后HRV的变化是暂时的,而不是减少发作的主要机制.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 耐药性 (DRE) 在管理方面存在重大挑战.
- 阴道神经刺激器 (VNS) 是对DRE的已知治疗方法.
- 心率变化 (HRV) 反映了自主神经系统的功能,并已被研究为潜在的生物标志物.
研究的目的:
- 审查和综合有关DRE患者VNS诱导的HRV变化的现有文献.
- 评估VNS植入后HRV变化和发作缓解之间的关系.
- 探索VNS在的疗效的潜在机制.
主要方法:
- 进行了范围范围的文献审查.
- 收录标准:英语主要文章,人体VNS植入物,HRV作为主要结果.
- 分析了29项研究,并指出了显著的方法异质性.
主要成果:
- DRE患者的抑郁HRV在VNS后持续存在,这表明"健康"HRV对治疗成功并不重要.
- 在DRE患者的频率域HRV参数在VNS植入后一年恢复到基线水平.
- 发作减少的VNS的主要机制似乎与基线HRV修改没有显著联系.
结论:
- 对于DRE的VNS治疗是有效的,不管达到正常HRV水平.
- VNS对发作负担的影响并没有通过HRV变化得到实质性的介导.
- 需要使用标准化方法进行进一步的研究,以阐明VNS有效性所涉及的复杂自主信号.
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