深度大脑刺激对自闭症和严重智力障碍儿科患者耐火侵略的有效性:元分析性综述
Jorge Herrera-Pino1, Juancarlos Benedetti-Isaac2,3, Daniela Ripoll-Córdoba4
1College of Medicine, Florida International University, 11200 SW 8Th St, Miami, FL, 33199, USA.
BMC pediatrics
|July 30, 2024
概括
深度大脑刺激 (DBS) 显示出治疗自闭症 (ASD) 和智力障碍 (ID) 的儿科患者严重侵略的希望. 虽然在94.2%的病例中有效,但谨慎的患者选择和严格的研究设计对于最佳结果至关重要.
科学领域:
- 神经科学是一个神经科学.
- 儿科精神病学 儿科精神病学
- 手术神经病学 手术神经病学
背景情况:
- 儿科自闭症 (ASD) 和智力障碍 (ID) 中的阻断性侵略带来了重大挑战.
- 传统的治疗方法往往是无效的,可能会使症状恶化.
- 深度大脑刺激 (DBS) 提供了一个潜在的治疗途径,儿童证据有限.
研究的目的:
- 分析DBS在患有ASD和严重ID的儿科患者的强迫性侵略的疗效和安全性.
- 审查现有文献,并评估该人群中DBS的证据质量.
主要方法:
- 根据PRISMA标准对Web of Science和Scopus数据库进行元分析审查.
- 包括与被诊断为ASD或ID的儿科患者进行的研究,使用经过验证的计量表 (OAS,MOAS) 以至少12个月的随访来测量DBS前后的侵略性.
- 使用适应的NOS尺度进行质量评估,以评估偏见和研究设计.
主要成果:
- 分析包括65名儿科患者 (平均年龄为16.8岁);51人进行了≥12个月的随访.
- 在94.2% (48/51) 的患者中观察到显著的临床改善,具有相当大的效果大小 (OAS:d=4.32;MOAS:d=1.46).
- 在13/65名受试者中发生了不良反应;后介质下丘脑核 (pHypN) 显示出最佳的风险-益处概况.
结论:
- 在小儿ASD/ID患者中,DBS可以安全有效地治疗难治的侵略性.
- 发现高效率 (94.2%),但仅在使用严格方法的研究中.
- 最佳的结果需要严格的患者选择,跨学科评估,客观的尺度和确定的手术目标.
相关概念视频
01:19Autism Spectrum Disorder
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Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by persistent deficits in social communication and interaction alongside restrictive and repetitive behaviors or interests. ASD is sometimes accompanied by intellectual impairment.
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
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01:24Operant Conditioning Intervention
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01:21Behavior Modification
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