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非侵入性脑刺激改善脑出血后功能恢复及预测预后:一项叙述性综述

Non-Invasive Brain Stimulation to Improve Functional Recovery and Predict Outcome After Intracerebral Hemorrhage: A Narrative Review.

作者信息

Zanola Daniele, Morotti Andrea, Padovani Alessandro

机构信息

Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy.

Department of Continuity of Care and Frailty, ASST Spedali Civili, 25123 Brescia, Italy.

出版信息

J Clin Med. 2025 Jan 10;14(2):398. doi: 10.3390/jcm14020398.


DOI:10.3390/jcm14020398
PMID:39860404
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11765871/
Abstract

Intracerebral hemorrhage (ICH) is a leading cause of stroke-related mortality and long-term disability, with initial ICH volume, age, location of the hemorrhage, and clinical severity being key predictors of outcome. While clinical scores incorporating these elements are validated and exhibit good inter-rater reliability, their accuracy in predicting long-term recovery remains suboptimal. Non-invasive brain stimulation (NIBS) has emerged as a potential adjunct for improving both prognostication and functional recovery in ICH survivors. Despite promising results, heterogeneity in stimulation protocols, patients' populations, and outcome measures have prevented NIBS implementation in clinical practice. This narrative review summarizes the available evidence on the association between NIBS, outcome prediction and functional recovery, discussing current challenges and future perspectives.

摘要

脑出血(ICH)是与中风相关的死亡率和长期残疾的主要原因,初始脑出血量、年龄、出血部位和临床严重程度是预后的关键预测因素。虽然纳入这些因素的临床评分已经得到验证,并且具有良好的评分者间信度,但其在预测长期恢复方面的准确性仍然欠佳。非侵入性脑刺激(NIBS)已成为改善脑出血幸存者预后和功能恢复的一种潜在辅助手段。尽管取得了令人鼓舞的结果,但刺激方案、患者群体和结局指标的异质性阻碍了NIBS在临床实践中的应用。本叙述性综述总结了关于NIBS、预后预测和功能恢复之间关联的现有证据,讨论了当前的挑战和未来的前景。

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本文引用的文献

[1]
Vagus nerve stimulation for enhanced stroke recovery after intracerebral hemorrhage: illustrative case.

J Neurosurg Case Lessons. 2024-3-11

[2]
Functional outcome improvement from 3 to 12 months after intracerebral hemorrhage.

Eur Stroke J. 2024-6

[3]
Monophasic-quadri-burst stimulation robustly activates bilateral swallowing motor cortices.

Front Neurosci. 2023-5-25

[4]
Location-Specific Hematoma Volume Cutoff and Clinical Outcomes in Intracerebral Hemorrhage.

Stroke. 2023-6

[5]
rTMS treatment for abrogating intracerebral hemorrhage-induced brain parenchymal metabolite clearance dysfunction in male mice by regulating intracranial lymphatic drainage.

Brain Behav. 2023-7

[6]
Intracerebral haemorrhage.

Nat Rev Dis Primers. 2023-3-16

[7]
Effects and safety of high-frequency rTMS in acute intracerebral hemorrhage patients: A pilot study.

J Neurol Sci. 2022-12-15

[8]
One-Year Outcome Trajectories and Factors Associated with Functional Recovery Among Survivors of Intracerebral and Intraventricular Hemorrhage With Initial Severe Disability.

JAMA Neurol. 2022-9-1

[9]
Effect of High-Frequency Repetitive Peripheral Magnetic Stimulation on Motor Performance in Intracerebral Haemorrhage: A Clinical Trial.

J Stroke Cerebrovasc Dis. 2022-7

[10]
Transcranial Direct Current Stimulation Enhances Neuroplasticity and Accelerates Motor Recovery in a Stroke Mouse Model.

Stroke. 2022-5

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