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非侵入性脑刺激疗法促进意识恢复:我们在哪里以及我们应该去哪里。

Noninvasive Brain Stimulation Therapies to Promote Recovery of Consciousness: Where We Are and Where We Should Go.

机构信息

Coma Science Group, GIGA Consciousness - GIGA Research, University of Liège, Liège, Belgium.

Centre du Cerveau, University Hospital of Liège, Liège, Belgium.

出版信息

Semin Neurol. 2022 Jun;42(3):348-362. doi: 10.1055/s-0042-1755562. Epub 2022 Sep 13.

Abstract

Therapeutic options for patients with disorders of consciousness (DoC) are still underexplored. Noninvasive brain stimulation (NIBS) techniques modulate neural activity of targeted brain areas and hold promise for the treatment of patients with DoC. In this review, we provide a summary of published research using NIBS as therapeutic intervention for DoC patients, with a focus on (but not limited to) randomized controlled trials (RCT). We aim to identify current challenges and knowledge gaps specific to NIBS research in DoC. Furthermore, we propose possible solutions and perspectives for this field. Thus far, the most studied technique remains transcranial electrical stimulation; however, its effect remains moderate. The identified key points that NIBS researchers should focus on in future studies are (1) the lack of large-scale RCTs; (2) the importance of identifying the endotypes of responders; and (3) the optimization of stimulation parameters to maximize the benefits of NIBS.

摘要

治疗意识障碍(DOC)患者的选择仍然有限。非侵入性脑刺激(NIBS)技术可调节目标脑区的神经活动,有望成为治疗 DOC 患者的手段。在本综述中,我们总结了使用 NIBS 作为 DOC 患者治疗干预的已发表研究,重点关注(但不限于)随机对照试验(RCT)。我们旨在确定针对 DOC 的 NIBS 研究的当前挑战和知识空白。此外,我们还为该领域提出了可能的解决方案和展望。到目前为止,研究最多的技术仍然是经颅电刺激;然而,其效果仍然有限。NIBS 研究人员在未来研究中应关注的关键点是:(1)缺乏大规模 RCT;(2)确定反应者内表型的重要性;(3)优化刺激参数以最大化 NIBS 的益处。

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