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意識障害治療の革新：深部脳刺激の進歩に関する学際的レビュー

  • role： Corresponding author, Contribute equally, First author通信作者, 同等贡献者, 第一作者
  • Affiliation：

    Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

    China National Clinical Research Center for Neurological Diseases, Beijing 100070, China

    Innovative Center, Beijing Institute of Brain Disorders, Beijing 100070, China

    Department of Neurosur-gery, Chinese Institute for Brain Research, Beijing 100070, China

    Medi-cal Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 7BN, UK

  • Email：yangyi_81nk@163.com
  • Introduction：* Yi Yang yangyi_81nk@163.com
Yi Yang12345*,  
  • role： Contribute equally同等贡献者
  • Affiliation：

    Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

    China National Clinical Research Center for Neurological Diseases, Beijing 100070, China

Tian-Qing Cao12,  
  • role： Contribute equally同等贡献者
  • Affiliation：

    Medi-cal Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 7BN, UK

Sheng-Hong He5,  
  • Affiliation：

    Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China

Lu-Chen Wang6,  
  • Affiliation：

    Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

    China National Clinical Research Center for Neurological Diseases, Beijing 100070, China

Qi-Heng He12,  
  • Affiliation：

    National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100080, China

Ling-Zhong Fan7,  
  • Affiliation：

    Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China

Yong-Zhi Huang8,  
  • Affiliation：

    National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100080, China

Hao-Ran Zhang7,  
  • Affiliation：

    State Key Laboratory of Cognitive Neuroscience and Learn-ing, Beijing Normal University, Beijing 100080, China

Yong Wang9,  
  • Affiliation：

    Department of Neuro-surgery, Chinese PLA General Hospital, Beijing 100080, China

Yuan-Yuan Dang10,  
  • Affiliation：

    Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

    China National Clinical Research Center for Neurological Diseases, Beijing 100070, China

Nan Wang12,  
  • Affiliation：

    Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

    China National Clinical Research Center for Neurological Diseases, Beijing 100070, China

Xiao-Ke Chai12,  
  • Affiliation：

    Department of Neurosurgery, Ganzhou People’s Hospital, Ganzhou 341000, Jiangxi, China

Dong Wang11,  
  • Affiliation：

    Department of Neurosurgery, Ganzhou People’s Hospital, Ganzhou 341000, Jiangxi, China

Qiu-Hua Jiang11,  
  • Affiliation：

    School of Automation Science and Engineering, South China University of Technology, Guangzhou 510641, China

Xiao-Li Li12,  
  • role： Corresponding author通信作者
  • Affiliation：

    School of Electrical and Informa-tion Engineering, Tianjin University, Tianjin 300072, China

  • Email：liuchen715@tju.edu.cn
  • Introduction：Chen Liu liuchen715@tju.edu.cn
Chen Liu13*,  
  • role： Corresponding author通信作者
  • Affiliation：

    Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China

    School of Informa-tion Science and Technology, Fudan University, Shanghai 200433, China

  • Email：shouyan@fudan.edu.cn
  • Introduction：Shou-Yan Wang shouyan@fudan.edu.cn
Shou-Yan Wang614*

サマリー

意識障害（DOC）の治療に関する既存の研究の中で、深部脳刺激（DBS）は非常に有望な治療アプローチを提供します。本総合レビューは、DBSの歴史的発展とDOC治療における役割を記録し、実験的治療からメソサーキットモデル仮説に基づく詳細な調節アプローチへの進展をたどります。メソサーキットモデル仮説は、DOCが重要な脳領域のネットワークの障害に起因すると示唆し、DBSターゲットの洗練化の枠組みを提供します。また、臨床行動尺度、電気生理学的評価、神経画像技術を含むDOC患者の評価のための多モーダルアプローチについても議論します。DOC治療の進化の中で、中心核の分割、単一ニューロンの記録、局所場電位の解析は、DBS治療の有効性を高める有利な技術的要因として浮上してきました。計算モデルの進歩により、DOCに関連する神経ダイナミクスのより深い探究が可能になり、ニューロンレベルの動態と巨視的行動変化を結びつけています。有望な結果を示しているものの、患者選定、正確なターゲット局在、最適な刺激パラメータの決定には依然として課題があります。将来の研究は、DOCの病態生理学的メカニズムを深く掘り下げるための大規模な対照試験の実施に焦点を当てるべきです。DBSが視床皮質および皮質皮質機能的結合ネットワークに及ぼす正確な調節効果をさらに解明することが不可欠です。最終的には、神経調節戦略を最適化することで、治療効果を大幅に向上させ、患者の意識回復プロセスを大幅に加速することを目指します。

キーワード

深部脳刺激;意識障害;視床核の分割;局所場電位;計算モデリング

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