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Clinical neuromodulatory effects of deep brain stimulation in disorder of consciousness: A literature review.
Cao, Tianqing; He, Shenghong; Wang, Luchen; Chai, Xiaoke; He, Qiheng; Liu, Dongsheng; Wang, Dong; Wang, Nan; He, Jianghong; Wang, Shouyang; Yang, Yi; Zhao, Jizong; Tan, Huiling.
Afiliación
  • Cao T; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • He S; China National Clinical Research Center for Neurological Diseases, Beijing, China.
  • Wang L; Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
  • Chai X; School of Information Science and Technology, Fudan University, Shanghai, China.
  • He Q; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Liu D; China National Clinical Research Center for Neurological Diseases, Beijing, China.
  • Wang D; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Wang N; China National Clinical Research Center for Neurological Diseases, Beijing, China.
  • He J; Department of Neurosurgery, Aviation General Hospital, Beijing, China.
  • Wang S; Department of Neurosurgery, Ganzhou People's Hospital, Ganzhou, Jiangxi Province, China.
  • Yang Y; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
  • Zhao J; China National Clinical Research Center for Neurological Diseases, Beijing, China.
  • Tan H; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
CNS Neurosci Ther ; 30(6): e14559, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38115730
ABSTRACT

BACKGROUND:

The management of patients with disorders of consciousness (DOC) presents substantial challenges in clinical practice. Deep brain stimulation (DBS) has emerged as a potential therapeutic approach, but the lack of standardized regulatory parameters for DBS in DOC hinders definitive conclusions.

OBJECTIVE:

This comprehensive review aims to provide a detailed summary of the current issues concerning patient selection, target setting, and modulation parameters in clinical studies investigating the application of DBS for DOC patients.

METHODS:

A meticulous systematic analysis of the literatures was conducted, encompassing articles published from 1968 to April 2023, retrieved from reputable databases (PubMed, Embase, Medline, and Web of Science).

RESULTS:

The systematic analysis of 21 eligible articles, involving 146 patients with DOC resulting from acquired brain injury or other disorders, revealed significant insights. The most frequently targeted regions were the Centromedian-parafascicular complex (CM-pf) nuclei and central thalamus (CT), both recognized for their role in regulating consciousness. However, other targets have also been explored in different studies. The stimulation frequency was predominantly set at 25 or 100 Hz, with pulse width of 120 µs, and voltages ranged from 0 to 4 V. These parameters were customized based on individual patient responses and evaluations. The overall clinical efficacy rate in all included studies was 39.7%, indicating a positive effect of DBS in a subset of DOC patients. Nonetheless, the assessment methods, follow-up durations, and outcome measures varied across studies, potentially contributing to the variability in reported efficacy rates.

CONCLUSION:

Despite the challenges arising from the lack of standardized parameters, DBS shows promising potential as a therapeutic option for patients with DOC. However, there still remains the need for standardized protocols and assessment methods, which are crucial to deepen the understanding and optimizing the therapeutic potential of DBS in this specific patient population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos de la Conciencia / Estimulación Encefálica Profunda Límite: Humans Idioma: En Revista: CNS Neurosci Ther Asunto de la revista: NEUROLOGIA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos de la Conciencia / Estimulación Encefálica Profunda Límite: Humans Idioma: En Revista: CNS Neurosci Ther Asunto de la revista: NEUROLOGIA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido