Revolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulation

作者：Yi Yang, Tian-Wen Cao, Shenghong He, Luchen Wang, Qiheng He, Lingzhong Fan, Yongzhi Huang, Haoran Zhang, Yong Wang, Yuanyuan Dang, Nan Wang, Xiao-Ke Chai, Dong Wang, Qiuhua Jiang, Xiaoli Li, Chen Liu, Shouyan Wang · 发表于：Military Medical Research · 年份：2024 · DOI：10.1186/s40779-024-00585-w · 被引用次数：4 · 研究领域：Traumatic Brain Injury Research、Neurological disorders and treatments、Functional Brain Connectivity Studies

Among the existing research on the treatment of disorders of consciousness (DOC), deep brain stimulation (DBS) offers a highly promising therapeutic approach. This comprehensive review documents the historical development of DBS and its role in the treatment of DOC, tracing its progression from an experimental therapy to a detailed modulation approach based on the mesocircuit model hypothesis. The mesocircuit model hypothesis suggests that DOC arises from disruptions in a critical network of brain regions, providing a framework for refining DBS targets. We also discuss the multimodal approaches for assessing patients with DOC, encompassing clinical behavioral scales, electrophysiological assessment, and neuroimaging techniques methods. During the evolution of DOC therapy, the segmentation of central nuclei, the recording of single-neurons, and the analysis of local field potentials have emerged as favorable technical factors that enhance the efficacy of DBS treatment. Advances in computational models have also facilitated a deeper exploration of the neural dynamics associated with DOC, linking neuron-level dynamics with macroscopic behavioral changes. Despite showing promising outcomes, challenges remain in patient selection, precise target localization, and the determination of optimal stimulation parameters. Future research should focus on conducting large-scale controlled studies to delve into the pathophysiological mechanisms of DOC. It is imperative to further elucidate ...