在耐药儿科和成人中内神经调节的安全性
Cheng-Yen Kuo1,2, Filip Mivalt1, Raunak Singh1
1Departments of Neurology, Mayo Clinic, Rochester, MN.
Neurology
|January 23, 2026
概括
内神经调节通常对抗药性是安全的,但儿童和使用4导装置的人面临着弓弦效应的更高风险. 针对儿科患者需要量身定制的方法.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 生物医学工程 生物医学工程
背景情况:
- 内神经调节是成人耐药性 (DRE) 的关键治疗方法.
- 改善控制和将使用扩展到儿科患者群体是关键目标.
- 正在探索使用非标签的多器件和各种刺激参数以获得更好的结果,但安全数据有限.
研究的目的:
- 为了评估与不同内神经调节装置相关的不良事件 (AE) 率.
- 为了在各种设备类型,患者人口统计 (性别,年龄) 和特征中比较AE概况.
- 确定需要量身定制的安全考虑的特定风险和患者群体.
主要方法:
- 在单个中心对217名DRE患者进行内神经调节 (2004年8月至2024年12月) 的回顾性分析.
- 数据提取包括人口统计,病细节,程序信息和所有报告的不良事件 (AE).
- 患者按年龄分类:儿童 (<13岁),青少年 (13-18岁) 和成年人 (≥19岁).
主要成果:
- 整体AE率在两性之间是可比的,但女性的装置扩张率更高 (11.9%对1.9%).
- 常见的副作用包括与刺激相关的麻醉 (7.8%),感染 (4.1%) 和无症状的内出血 (3.7%).
- 儿童和接受4深度大脑刺激 (DBS) 的患者显示,弓弦效应的发生率显著更高.
结论:
- 内神经调节在不同患者群体中表现出可接受的安全性.
- 弓弦效应对儿科患者和那些使用4DBS系统的患者构成更高的风险.
- 优化安全,特别是在儿科DRE中,需要定制的设备设计和手术技术.
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