补充深度大脑刺激与持续的神经刺激用于儿童 (ADVANCE):一个部分随机的患者偏好试验
Hrishikesh Suresh1,2,3, Karim Mithani1,2,3, Nebras Warsi1,2,3
1Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
Annals of neurology
|June 1, 2024
概括
对于患有耐药性的儿童,将深度大脑刺激 (DBS) 添加到迷走神经刺激 (VNS) 中,可以显著减少比单独使用VNS更多的发作. 在VNS故障后,DBS可能会在更早的时间被考虑.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 儿科症 儿科症
背景情况:
- 随着时间的推移,神经刺激 (VNS) 的结果在儿科耐药性中得到改善.
- 添加深度大脑刺激 (DBS) 与持续VNS优化相比的好处尚未得到充分证实.
研究的目的:
- 为了比较额外的深度大脑刺激 (DBS) 与持续的迷走神经刺激 (VNS) 优化在没有响应VNS的耐药性的儿童中的疗效.
主要方法:
- 潜在的,非盲目的,随机的患者偏好试验.
- 18名儿童 (8-17岁) 患有耐药性,至少经过1年的VNS.
- 补充DBS和持续VNS优化之间的比较.
主要成果:
- 与VNS优化 (12.3%,p=0.047) 相比,添加DBS实现了显著更大的发作减少 (51.9%).
- 添加DBS也导致了不那么麻烦的发作 (p=0.03).
- 在任何一种方法中都没有观察到生活质量的显著变化.
结论:
- 深度大脑刺激 (DBS) 可能是一个有价值的早期治疗选择儿科耐药性,当迷走神经刺激 (VNS) 是无效的.
- 这项研究表明,儿童耐火性的治疗模式可能发生转变.
相关概念视频
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Long-term potentiation, or LTP, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTP is the process of synaptic strengthening that occurs over time between pre- and postsynaptic neuronal connections. The synaptic strengthening of LTP works in opposition to the synaptic weakening of long-term depression (LTD) and together are the main mechanisms that underlie learning and memory.
01:25Long-term Potentiation
Long-term potentiation, or LTP, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTP is the process of synaptic strengthening that occurs over time between pre and postsynaptic neuronal connections. The synaptic strengthening of LTP works in opposition to the synaptic weakening of long-term depression (LTD) and together are the main mechanisms that underlie learning and memory.
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