杏仁体作为攻击性和破坏性行为的治疗目标:系统性审查
Juan Camilo Salcedo-Moreno1, Fernando Peralta-Pizza1, Paola Vélez-Jimenez2
1Sección de Neurocirugía, Universidad del Valle, Cali, Colombia.
概括
杏仁体的神经调节,主要是通过杏仁体切除术,改善了超过70%的患者的破坏性行为. 这种干预措施也对患者的控制产生了积极影响.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 行为科学 行为科学
背景情况:
- 破坏性行为和严重影响患者的生活质量.
- 杏仁体在情绪调节和发作发作中发挥着至关重要的作用.
- 神经调节为这些疾病提供了潜在的治疗点.
研究的目的:
- 系统地审查杏仁体神经调节对破坏性行为的影响.
- 评估与这些干预相关的生活质量变化.
- 探索杏仁体神经调节,行为和之间的关系.
主要方法:
- 在多个数据库 (MEDLINE,OVID,WoS,Cochrane,Scopus) 进行全面的文献搜索,截至2023年3月.
- 包括对接受杏仁体手术或深度大脑刺激的极度侵略性患者进行至少六个月的随访研究.
- 对符合严格纳入标准的案例系列和案例报告进行分析.
主要成果:
- 确定了11个病例系列和3个病例报告,涉及1,033名患者 (主要是男性,5-61岁).
- 在大多数研究中进行的杏仁切除术,导致超过70%的患者的行为改善.
- 发作发生在大约30%的患者中,40%的患者经历了发作改善;两项研究报告了行为恶化.
结论:
- 杏仁切除术对患者的行为和控制产生了积极的影响.
- 需要进一步的高功率研究来证实这些发现.
- 未来的研究应该探索深度大脑刺激和连接学在杏仁体神经调节中的作用.
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