Chung Melissa G, Lo Warren D
Division of Critical Care, Columbus, OH; Division of Neurology, Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, OH.
Division of Neurology, Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, OH.
Arch Phys Med Rehabil. 2015 Apr;96(4 Suppl):S129-37. doi: 10.1016/j.apmr.2014.10.013. Epub 2014 Nov 6.
Noninvasive brain stimulation (NIBS) offers the potential to modulate neural activity and recovery after acquired brain injury. There are few studies of NIBS in children, but a survey of those studies might provide insight into the potential for NIBS to modulate motor rehabilitation, seizures, and behavior in children. We surveyed the published literature prior to July 2014 for articles pertaining to children and NIBS with a focus on case series or trials. We also reviewed selected articles involving adults to illustrate specific points where the literature in children is lacking. A limited number of articles suggest that NIBS can transiently improve motor function. The evidence for an effect on seizures is mixed. Two open-label studies reported improvement of mood in adolescents with depression. NIBS may serve as a tool for pediatric neurorehabilitation, but many gaps in our knowledge must be filled before NIBS can be adopted as a clinical intervention. To move forward, the field needs adequately powered trials that can answer these questions. Such trials will be challenging to perform, will likely require multicenter collaboration, and may need to adopt novel trial designs that have been used with rare disorders.
无创脑刺激（NIBS）为后天性脑损伤后调节神经活动和促进恢复提供了可能。关于NIBS在儿童中的研究较少，但对这些研究进行综述可能有助于深入了解NIBS调节儿童运动康复、癫痫发作和行为的潜力。我们检索了2014年7月之前发表的文献，查找与儿童和NIBS相关的文章，重点关注病例系列或试验。我们还查阅了一些涉及成人的文章，以说明儿童相关文献中存在的特定不足之处。少数文章表明，NIBS可短暂改善运动功能。关于其对癫痫发作的影响，证据不一。两项开放标签研究报告称，NIBS可改善青少年抑郁症患者的情绪。NIBS可能成为儿科神经康复的一种工具，但在将其作为临床干预措施采用之前，我们在很多方面的认知空白仍需填补。为了取得进展，该领域需要有足够效力的试验来回答这些问题。进行此类试验将具有挑战性，可能需要多中心合作，并且可能需要采用针对罕见疾病的新型试验设计。
