切换至 "中华医学电子期刊资源库"
高级检索
中华脑科疾病与康复杂志(电子版)

中华脑科疾病与康复杂志(电子版) ›› 2019, Vol. 09 ›› Issue (03) : 181 -184. doi: 10.3877/cma.j.issn.2095-123X.2019.03.013

所属专题： 文献；

综述

经颅直流电刺激神经调控治疗慢性意识障碍的现状及前景
郭永坤1, 戴宜武2, 刘春颖1,†(), 白洋3, 何江弘2, 张辉1   
  1. 1. 450007　郑州，郑州大学附属郑州中心医院神经外科
    2. 100700　北京，解放军总医院第七医学中心神经外科
    3. 311121　杭州，杭州师范大学基础医学院
  • 收稿日期:2018-10-11 出版日期:2019-06-15
  • 通信作者: 刘春颖
  • 基金资助:
    广东省重点领域研发计划项目(2018B030339001); 河南省高等学校重点科研项目(19A320041；18B310037)

Current status of transcranial direct current stimulation neuromodulation therapy for chronic disorders of consciousness

Yongkun Guo1, Yiwu Dai2, Chunying Liu1,†(), Yang Bai3, Jianghong He2, Hui Zhang1   

  1. 1. Department of Neurosurgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China
    2. Department of Neurosurgery, The 7th Medical Center of the Chinese People’s Liberation Army General Hospital, Beijing 100700, China
    3. School of Basic Medical Science, Hangzhou Normal University, Hangzhou 311121, China
  • Received:2018-10-11 Published:2019-06-15
  • Corresponding author: Chunying Liu
  • About author:
    Corresponding author: Liu Chunying, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

郭永坤, 戴宜武, 刘春颖, 白洋, 何江弘, 张辉. 经颅直流电刺激神经调控治疗慢性意识障碍的现状及前景[J]. 中华脑科疾病与康复杂志(电子版), 2019, 09(03): 181-184.

Yongkun Guo, Yiwu Dai, Chunying Liu, Yang Bai, Jianghong He, Hui Zhang. Current status of transcranial direct current stimulation neuromodulation therapy for chronic disorders of consciousness[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2019, 09(03): 181-184.

严重脑损伤导致的意识障碍（DOC），目前尚未有基于循证医学依据的指南。经颅直流电刺激（tDCS）是神经调控治疗DOC非常有前景的技术，已成为昏迷促醒治疗研究的热点。本文围绕tDCS的治疗效果、刺激参数、刺激靶点及促醒机制等方面的研究现状展开综述。

关键词: 经颅直流电刺激, 意识障碍, 脑电图, 核磁共振

Patients after severe brain injuries would be disorders of consciousness (DOC), but evidence-based guidelines on the treatment of DOC patients are not currently available. Transcranial direct current stimulation (tDCS) has been reported to be a promising technique for consciousness improvement for patients with DOC, becoming a new hotspot in the research field. This article reviews the current research status of tDCS in terms of therapeutic effect, stimulation parameters, stimulation targets and the arousal mechanism.

Key words: Transcranial direct current stimulation, Disorders of consciousness, Electroencephalography, Magnetic resonance imaging
[1]
Monti MM, Laureys S, Owen AM. The vegetative state[J]. BMJ, 2010, 341: c3765.
[2]
Bruno MA, Majerus S, Boly M, et al. Functional neuroanatomy underlying the clinical subcategorization of minimally conscious state patients[J]. J Neurol, 2012, 259(6): 1087-1098.
[3]
Thibaut A, Bruno MA, Ledoux D, et al. tDCS in patients with disorders of consciousness: sham-controlled randomized double-blind study[J]. Neurology, 2014, 82(13): 1112-1118.
[4]
Xia X, Yang Y, Guo Y, et al. Current status of neuromodulatory therapies for disorders of consciousness[J]. Neurosci Bull, 2018, 34(4): 615-625.
[5]
Schnakers C, Monti MM. Disorders of consciousness after severe brain injury: therapeutic options[J]. Curr Opin Neurol, 2017, 30(6): 573-579.
[6]
Stagg CJ, Nitsche MA. Physiological basis of transcranial direct current stimulation[J]. Neuroscientist, 2011, 17(1): 37-53.
[7]
Nikolin S, Huggins C, Martin D, et al. Safety of repeated sessions of transcranial direct current stimulation: a systematic review[J]. Brain Stimul, 2018, 11(2): 278-288.
[8]
Naro A, Calabrò RS, Russo M, et al. Can transcranial direct current stimulation be useful in differentiating unresponsive wakefulness syndrome from minimally conscious state patients?[J]. Restor Neurol Neurosci, 2015, 33(2): 159-176.
[9]
Angelakis E, Liouta E, Andreadis N, et al. Transcranial direct current stimulation effects in disorders of consciousness[J]. Arch Phys Med Rehabil, 2014, 95(2): 283-289.
[10]
Thibaut A, Wannez S, Donneau AF, et al. Controlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state[J]. Brain Inj, 2017, 31(4): 466-474.
[11]
Huang W, Wannez S, Fregni F, et al. Repeated stimulation of the posterior parietal cortex in patients in minimally conscious state: a sham-controlled randomized clinical trial[J]. Brain Stimul, 2017, 10(3): 718-720.
[12]
Estraneo A, Pascarella A, Moretta P, et al. Repeated transcranial direct current stimulation in prolonged disorders of consciousness: a double-blind cross-over study[J]. J Neurol Sci, 2017, 15(375): 464-470.
[13]
Bai Y, Xia X, Wang Y, et al. Fronto-parietal coherence response to tDCS modulation in patients with disorders of consciousness[J]. Int J Neurosci, 2018, 128(7): 587-594.
[14]
Bai Y, Xia X, Kang J, et al. TDCS modulates cortical excitability in patients with disorders of consciousness[J]. Neuroimage Clin, 2017, 15: 702-709.
[15]
赵敬璞，倪莹莹，林瀚波，等.经颅直流电刺激对最小意识状态患者脑功能网络的即刻效应研究[J].中国康复医学杂志, 2018, 33(3):259-263.
[16]
Luauté JJ, Maucort-Boulch D, Tell L, et al. Long-term outcomes of chronic minimally conscious and vegetative states[J]. Neurology, 2010, 75(3): 246-252.
[17]
Transcranial direct current stimulation in patients with prolonged disorders of consciousness: combined behavioral and event-related potential evidence[J]. Front Neurol, 2017, 8: 620.
[18]
Martens G, Lejeune N, O’Brien AT, et al. Randomized controlled trial of home-based 4-week tDCS in chronic minimally conscious state[J]. Brain Stimul, 2018, 11(5): 982-990.
[19]
黄王姗. tDCS刺激MCS患者楔前叶的随机双盲临床研究[D].杭州:杭州师范大学, 2016.
[20]
Naro A, Bramanti P, Leo A, et al. Transcranial alternating current stimulation in patients with chronic disorder of consciousness: a possible way to cut the diagnostic Gordian knot?[J]. Brain Topogr, 2016, 29(4): 623-644.
[21]
Naro A, Russo M, Leo A, et al. Cortical connectivity modulation induced by cerebellar oscillatory transcranial direct current stimulation in patients with chronic disorders of consciousness: a marker of covert cognition?[J]. Clin Neurophysiol, 2016, 127(3): 1845-1854.
[22]
Thibaut A, Chennu S, Chatelle C, et al. Theta network centrality correlates with tDCS response in disorders of consciousness[J]. Brain Stimul, 2018, 11(6): 1407-1409.
[23]
Cavaliere C, Aiello M, Di Perri C, et al. Functional connectivity substrates for tDCS response in minimally conscious state patients[J]. Front Cell Neurosci, 2016, 10: 257.
[24]
Giacino JT, Fins JJ, Laureys S, et al. Disorders of consciousness after acquired brain injury: the state of the science[J]. Nat Rev Neurol, 2014, 10(2): 99-114.
[25]
Thibaut A, Di Perri C, Chatelle C, et al. Clinical response to tdcs depends on residual brain metabolism and grey matter integrity in patients with minimally conscious state[J]. Brain Stimul, 2015, 8(6): 1116-1123.
[1] 李文琳, 羊玲, 邢凯慧, 陈彩华, 钟丽花, 张娅琴, 张薇. 脐动脉血血气分析联合振幅整合脑电图对新生儿窒息脑损伤的早期诊断价值分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 550-558.
[2] 龙珂, 戴祝, 刘全辉. 关节镜下肩袖修补联合喙突成形治疗肩袖撕裂合并喙突下囊肿[J]. 中华肩肘外科电子杂志, 2023, 11(03): 198-203.
[3] 冀京雷, 李秀丽, 贾亚男, 冯会敏, 刘丽艳. 改良aEEG评分评估高危足月低体质量新生儿脑损伤的效果分析[J]. 中华神经创伤外科电子杂志, 2023, 09(03): 165-169.
[4] 张永明. 颈段脊髓电刺激治疗颅脑损伤后慢性意识障碍的进展[J]. 中华神经创伤外科电子杂志, 2023, 09(03): 129-134.
[5] 李青华, 靳晨彦, 王艳军, 庄禹童, 何江弘, 郭文治. 七氟醚与丙泊酚对慢性意识障碍患者全身麻醉期间脑电的影响[J]. 中华神经创伤外科电子杂志, 2023, 09(01): 12-18.
[6] 吴新高, 李伟, 马俊, 刘红, 黄平. 癫痫患者定量脑电图功率谱相关参数与认知功能损伤的相关性研究[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(05): 304-308.
[7] 杨新宇, 彭建文, 李辉萍, 陶希, 方翠霓, 宋涛. 脑电非线性分析在卒中后意识障碍的研究进展[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(03): 185-190.
[8] 梁雪琴, 李娜, 潘芳芳, 张香玉, 段亚男. tDCS结合肌电生物反馈对脑梗死后偏瘫老年患者肢体功能、运动功能和动态姿势稳定性的影响[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 90-96.
[9] 梁玉兰, 陈亮, 曾令梅. NLR、RDW水平联合振幅整合脑电图在缺氧缺血性脑病患儿的预后研究[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 84-89.
[10] 姜佳慧, 毕鸿雁. 基于虚拟现实技术施经颅直流电刺激对脑卒中患者上肢功能影响的Meta分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 75-83.
[11] 丁浩然, 关宇光, 王雄飞, 赵萌, 王静, 王梦阳, 滕鹏飞, 栾国明. 立体定向脑电图引导下多电极立体适形射频热凝毁损治疗药物难治性岛叶癫痫的疗效分析[J]. 中华脑科疾病与康复杂志(电子版), 2022, 12(04): 227-233.
[12] 沈伶俐, 刘晓鸣, 李玮玮, 夏露, 周强. 自身免疫性脑炎患儿视频脑电图监测期间基于共享信息系统的协同干预模式的作用分析[J]. 中华脑科疾病与康复杂志(电子版), 2022, 12(03): 162-166.
[13] 李变, 王莉娜, 桑田, 李珊, 杜雪燕, 李春华, 张兴云, 管巧, 王颖, 冯琪, 蒙景雯. 亚低温技术治疗缺氧缺血性脑病新生儿的临床分析[J]. 中华临床医师杂志(电子版), 2023, 17(06): 639-643.
[14] 王志文, 郑雪梅, 张庆坤, 王海江. 自发性低颅压综合征75例临床分析[J]. 中华临床医师杂志(电子版), 2023, 17(04): 398-401.
[15] 张青岛, 王华龙. MRI表观弥散系数及体素内不相干运动参数对中老年患者肺结节性质的鉴别诊断价值[J]. 中华老年病研究电子杂志, 2023, 10(01): 26-29.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号