Department of Neurosurgery, PLA Army General Hospital, Beijing, 100700, China.
Department of Neurosurgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007, China.
Neurosci Bull. 2018 Aug;34(4):615-625. doi: 10.1007/s12264-018-0244-4. Epub 2018 Jun 18.
Treatment for disorders of consciousness (DOCs) is still a Gordian knot. Evidence-based guidelines on the treatment of DOC patients are not currently available, while neuromodulation techniques are seen as a potential treatment. Multiple neuromodulation therapies have been applied. This article reviews the most relevant studies in the literature in order to describe a clear picture of the current state of neuromodulation therapies that could be used to treat DOC patients. Both invasive and non-invasive brain stimulation is discussed. Significant behavioral improvements in prolonged DOCs under neuromodulation therapies are rare. The efficacy of various such therapies remains a matter of debate. Further clinical investigations of existing techniques in larger samples properly controlling for spontaneous recovery are needed, and new approaches are awaited.
意识障碍(DOC)的治疗仍然是一个棘手的问题。目前尚无针对 DOC 患者治疗的循证指南,而神经调节技术被视为一种潜在的治疗方法。已经应用了多种神经调节疗法。本文综述了文献中最相关的研究,以描述可用于治疗 DOC 患者的神经调节疗法的现状。本文讨论了侵入性和非侵入性脑刺激。在神经调节治疗下,长时间的 DOC 患者的行为改善并不常见。各种神经调节治疗的疗效仍存在争议。需要在更大的样本中,通过适当控制自发恢复,对现有技术进行进一步的临床研究,并期待新的方法。