神经调节和意识障碍:系统审查和病理生理学
Rajeev R Dutta1, Sheila Abdolmanafi2, Alex Rabizadeh2
1School of Medicine, University of California Irvine, Irvine, CA, USA.
概括
神经调节,包括深度大脑刺激和重复性经磁性刺激,显示出治疗意识障碍 (DoC) 的潜力. 虽然结果各不相同,但深度大脑刺激似乎更有效,尽管像rTMS这样的侵入性较小的选择也显示出希望.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 康复医学 康复医学 康复医学
背景情况:
- 意识障碍 (DoC) 影响着成千上万的人,药物治疗有限.
- 神经调节正在被探索为DoC的替代治疗方法.
- 系统性审查,以评估DoC治疗中神经调节的证据.
研究的目的:
- 系统地审查关于神经调节技术治疗意识障碍的证据.
- 评估不同神经调节方式的疗效和侵入性.
主要方法:
- 按照PRISMA指南进行系统的文献审查.
- 在PubMed,Scopus和Web of Science数据库中进行了搜索 (1990-2023年).
- 包括针对DoC的人类和动物研究,不包括那些不关注DoC的研究.
主要成果:
- 69项研究 (58人,11动物) 符合标准,涉及1000多名患者和150只动物.
- 深度大脑刺激 (DBS) 和跨磁刺激 (TMS) 在人类中是最受研究的.
- 动物研究主要使用DBS和TMS.
结论:
- 与其他方法相比,深度大脑刺激在DoC中显示出更大的改善.
- 重复性横磁性刺激 (rTMS) 显示出具有较低侵入性的临床潜力.
- 临床结果是混合的,并可能因自然恢复或药理干预而混.
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