脊髓刺激和深部脑刺激治疗意识障碍：608 例的系统评价和个体患者数据分析。
Spinal cord stimulation and deep brain stimulation for disorders of consciousness: a systematic review and individual patient data analysis of 608 cases.
机构信息
Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, Sichuan Province, China.
Department of Histoembryology and Neurobiology, West China College of Basic Medicine and Forensic Medicine, Sichuan University, Chengdu, Sichuan Province, China.
出版信息
Neurosurg Rev. 2023 Aug 14;46(1):200. doi: 10.1007/s10143-023-02105-1.
The application of spinal cord stimulation (SCS) and deep brain stimulation (DBS) for disorders of consciousness (DoC) has been increasingly reported. However, there is no sufficient evidence to determine how effective and safe SCS and DBS are for DoC owing to various methodological limitations. We conducted a systematic review to elucidate the safety and efficacy of SCS and DBS for DoC by systematically reviewing related literature by searching PubMed, EMBASE, Medline, and Cochrane Library. Twenty eligible studies with 608 patients were included in this study. Ten studies with 508 patients reported the efficacy of SCS for DoC, and the estimated overall effectiveness rate was 37%. Five studies with 343 patients reported the efficacy of SCS for VS, and the estimated effectiveness rate was 30%. Three studies with 53 patients reported the efficacy of SCS for MCS, and the estimated effectiveness rate was 63%. Five studies with 92 patients reported the efficacy of DBS for DoC, and the estimated overall effectiveness rate was 40%. Four studies with 63 patients reported the efficacy of DBS for VS, and the estimated effectiveness rate was 26%. Three studies with 19 patients reported the efficacy of DBS for MCS, and the estimated effectiveness rate was 74%. The adverse event rate of DoC was 8.1% and 18.2% after SCS and DBS, respectively. These results suggest that SCS and DBS can be considered reasonable treatments for DoC with considerable efficacy and safety.
脊髓刺激 (SCS) 和深部脑刺激 (DBS) 在意识障碍 (DoC) 中的应用已越来越多地被报道。然而，由于各种方法学限制，尚无足够证据确定 SCS 和 DBS 对 DoC 的有效性和安全性。我们通过检索 PubMed、EMBASE、Medline 和 Cochrane Library 等相关文献，进行了系统评价，以阐明 SCS 和 DBS 治疗 DoC 的安全性和有效性。这项研究纳入了 20 项符合条件的研究，共涉及 608 例患者。其中 10 项研究（508 例患者）报告了 SCS 治疗 DoC 的疗效，估计总有效率为 37%。5 项研究（343 例患者）报告了 SCS 治疗 VS 的疗效，估计有效率为 30%。3 项研究（53 例患者）报告了 SCS 治疗 MCS 的疗效，估计有效率为 63%。5 项研究（92 例患者）报告了 DBS 治疗 DoC 的疗效，估计总有效率为 40%。4 项研究（63 例患者）报告了 DBS 治疗 VS 的疗效，估计有效率为 26%。3 项研究（19 例患者）报告了 DBS 治疗 MCS 的疗效，估计有效率为 74%。DoC 患者在接受 SCS 和 DBS 治疗后，不良事件发生率分别为 8.1%和 18.2%。这些结果表明，SCS 和 DBS 可被视为治疗 DoC 的合理方法，具有相当的疗效和安全性。
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