Jiao Dian, Xu Lai, Gu Zhen, Yan Hua, Shen Dingding, Gu Xiaosong
Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.
Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, Zhejiang Province, China.
Neural Regen Res. 2025 Apr 1;20(4):917-935. doi: 10.4103/NRR.NRR-D-23-01444. Epub 2024 Apr 3.
Epilepsy is a severe, relapsing, and multifactorial neurological disorder. Studies regarding the accurate diagnosis, prognosis, and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy. The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression, protein expression, ion channel activity, energy metabolites, and gut microbiota composition. Satisfactory results are lacking for conventional treatments for epilepsy. Surgical resection of lesions, drug therapy, and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy. Non-pharmacological treatments, such as a ketogenic diet, gene therapy for nerve regeneration, and neural regulation, are currently areas of research focus. This review provides a comprehensive overview of the pathogenesis, diagnostic methods, and treatments of epilepsy. It also elaborates on the theoretical basis, treatment modes, and effects of invasive nerve stimulation in neurotherapy, including percutaneous vagus nerve stimulation, deep brain electrical stimulation, repetitive nerve electrical stimulation, in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation. Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures. Additionally, many new technologies for the diagnosis and treatment of epilepsy are being explored. However, current research is mainly focused on analyzing patients' clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level, which has led to a lack of consensus regarding the mechanisms related to the disease.
癫痫是一种严重的、复发性的、多因素的神经系统疾病。关于准确诊断、预后及深入发病机制的研究对于癫痫的精准有效治疗至关重要。癫痫的发病机制复杂,涉及基因表达、蛋白质表达、离子通道活性、能量代谢产物及肠道微生物群组成等变量的改变。癫痫的传统治疗缺乏令人满意的效果。临床实践中主要采用手术切除病灶、药物治疗及非药物干预来治疗与癫痫相关的疼痛。非药物治疗,如生酮饮食、神经再生基因治疗及神经调节,是目前的研究热点领域。本综述全面概述了癫痫的发病机制、诊断方法及治疗。它还阐述了神经治疗中侵入性神经刺激的理论基础、治疗模式及效果,包括经皮迷走神经刺激、深部脑电刺激、重复神经电刺激,以及非侵入性经颅磁刺激和经颅直流电刺激。众多研究表明,电磁刺激介导的神经调节疗法可显著改善神经功能并降低癫痫发作频率。此外,正在探索许多用于癫痫诊断和治疗的新技术。然而,目前的研究主要集中在分析患者的临床表现并探索相关诊断和治疗方法以在分子水平研究发病机制,这导致对于该疾病相关机制缺乏共识。