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反应性神经刺激在难治性癫痫治疗中的作用:临床结果的系统评价

Role of Responsive Neurostimulation in Managing Drug-Resistant Epilepsy: A Systematic Review of Clinical Outcomes.

作者信息

Mushtaq Omid, Grezenko Han, Rehman Abdur, Sher Hamza, Sher Zarrar, Anyang Kaakyire Delphyne, Hanifullah Syed, Dabas Muath, Saleh Ghaida, Shehryar Abdullah, Khan Isa

机构信息

Diagnostic and Interventional Radiology, Sakarya University Faculty of Medicine, Sakarya, TUR.

Medicine and Surgery, Guangxi Medical University, Nanning, CHN.

出版信息

Cureus. 2024 Aug 28;16(8):e68032. doi: 10.7759/cureus.68032. eCollection 2024 Aug.

Abstract

Drug-resistant epilepsy remains a substantial challenge in neurology, affecting patients who do not respond to conventional antiepileptic drugs. Responsive neurostimulation (RNS) has emerged as a promising therapeutic approach, yet comprehensive reviews synthesizing its clinical outcomes are sparse. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and involved a comprehensive database search through PubMed, Medline, Embase, the Cochrane Library, and Scopus, covering literature up to April 2024. The review targeted peer-reviewed articles evaluating the efficacy, safety, and quality of life impacts of RNS in patients with drug-resistant epilepsy. Key inclusion criteria encompassed clinical trials, cohort studies, and meta-analyses, while exclusion criteria included non-peer-reviewed and irrelevant studies. We identified five studies meeting our inclusion criteria. These studies collectively demonstrated that RNS significantly reduces seizure frequency and improves quality of life, while maintaining a favorable safety profile. Despite small sample sizes and potential selection biases, the benefits of RNS appeared consistent across diverse patient demographics. RNS represents a viable and effective treatment option for drug-resistant epilepsy, offering significant improvements in seizure control and patient quality of life. Future research should focus on long-term outcomes and refining patient selection to optimize the therapeutic benefits of RNS. The integration of RNS into standard epilepsy management protocols is recommended based on current evidence.

摘要

耐药性癫痫仍然是神经病学领域的一项重大挑战,影响着那些对传统抗癫痫药物没有反应的患者。响应性神经刺激(RNS)已成为一种有前景的治疗方法,但综合其临床结果的全面综述却很少。本系统综述遵循系统评价和Meta分析的首选报告项目(PRISMA)指南,通过PubMed、Medline、Embase、Cochrane图书馆和Scopus进行了全面的数据库搜索,涵盖截至2024年4月的文献。该综述针对评估RNS对耐药性癫痫患者疗效、安全性和生活质量影响的同行评审文章。关键纳入标准包括临床试验、队列研究和Meta分析,而排除标准包括非同行评审和不相关的研究。我们确定了五项符合我们纳入标准的研究。这些研究共同表明,RNS能显著降低癫痫发作频率并改善生活质量,同时保持良好的安全性。尽管样本量小且存在潜在的选择偏倚,但RNS的益处似乎在不同患者群体中是一致的。RNS是耐药性癫痫一种可行且有效的治疗选择,在癫痫控制和患者生活质量方面有显著改善。未来的研究应关注长期结果并优化患者选择,以优化RNS的治疗益处。基于目前的证据,建议将RNS纳入标准癫痫管理方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9bc/11431993/3c7f9c4d0c68/cureus-0016-00000068032-i01.jpg

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