难治性癫痫反应性神经电刺激治疗进展  

Progress on responsive neurostimulation in treatment of drug-resistant epilepsy

作　　者：樊修良 白宇彤 杨岸超[1,2,3] 张凯 FAN Xiu-liang;BAI Yu-tong;YANG An-chao;ZHANG Kai(Center of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Beijing Neurosurgical Institute,Beijing Key Laboratory of Neurostimulation,Capital Medical University,Beijing 100070,China;National Engineering Research Center for Neuromodulation,Beijing 100084,China)

机构地区：[1]首都医科大学附属北京天坛医院神经外科学中心,100070 [2]首都医科大学北京市神经外科研究所、神经电刺激研究与治疗北京市重点实验室,100070 [3]神经调控国家工程研究中心,北京100084

出　　处：《中国现代神经疾病杂志》2025年第1期11-16,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家重点研发计划项目(项目编号:2021YFC2401201);国家自然科学基金资助项目(项目编号:82402252);国家自然科学基金资助项目(项目编号:82371267)。

摘　　要：癫痫是常见的慢性神经系统疾病,约1/3最终诊断为难治性癫痫,传统药物和手术治疗效果有限,反应性神经电刺激作为一种闭环神经调控技术,为难治性癫痫患者提供新的治疗选择。反应性神经电刺激通过植入式电极实时监测脑电活动,识别癫痫发作前兆并进行电刺激干预,有效减少癫痫发作频率和强度。本文综述反应性神经电刺激的组成、刺激参数选择与动态调整、长期数据记录与分析、与机器学习算法的融合、临床应用进展及其与迷走神经刺激术的比较,探讨其面临的技术挑战并展望未来发展方向,以为更多难治性癫痫患者提供精准的个性化治疗并扩展至其他神经系统疾病的治疗中。Epilepsy is a common chronic neurological disorder that severely impacts the quality of life and social functioning.Approximately 1/3 of patients are diagnosed with drug-resistant epilepsy(DRE),for which conventional antiepileptic seizure medicine(ASM)and traditional surgery have limited efficacy.In recent years,responsive neurostimulation(RNS),as a closed-loop neuromodulation technique,has provided a novel treatment option for DRE.The RNS utilizes invasived electrodes to monitor brain activity in real time,detect seizure precursors,and deliver electrical stimulation,effectively reducing the frequency and severity of DRE.This paper aims to review the composition of the RNS,optimization and dyanmic adjustment of stimulation parameters,long-term data recording and analysis,fusion with machine learning,clinical efficacy,and comparison with vagus nerve stimulation(VNS).It also explores the technical challenges and discusses future development directions.RNS holds promise for providing personalized and precise treatment to more DRE and expanding its application to other neurological disorders.

关 键 词：耐药性癫痫 电刺激疗法 迷走神经刺激术 综述 

分 类 号：R742.1[医药卫生—神经病学与精神病学]