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意识障碍的神经调节治疗现状。

Current Status of Neuromodulatory Therapies for Disorders of Consciousness.

机构信息

Department of Neurosurgery, PLA Army General Hospital, Beijing, 100700, China.

Department of Neurosurgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007, China.

出版信息

Neurosci Bull. 2018 Aug;34(4):615-625. doi: 10.1007/s12264-018-0244-4. Epub 2018 Jun 18.

Abstract

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.

摘要

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。

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