Clinical neuromodulatory effects of deep brain stimulation in disorder of consciousness: A literature review

作者：Tianqing Cao, Shenghong He, Luchen Wang, Xiaoke Chai, Qiheng He, Dongsheng Liu, Dong Wang, Nan Wang, Jianghong He, Shouyang Wang, Yi Yang, Jizong Zhao, Huiling Tan · 发表于：CNS Neuroscience & Therapeutics · 年份：2023 · DOI：10.1111/cns.14559 · 被引用次数：22 · 研究领域：Neurological disorders and treatments、Traumatic Brain Injury Research、Transcranial Magnetic Stimulation Studies

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 positiv...