迷走神经刺激对难治性癫痫疗效的预测指标

Predictors of efficacy before vagus nerve stimulation in drug-resistant epilepsy

迷走神经刺激是治疗药物难治性癫痫的有效手段,经过20余年的临床实践经验,其有效性与安全性得到充分验证。但由于作用机制尚未明确,目前仍无可靠预测指标来评估可能从迷走神经刺激术中获益的难治性癫痫患者。研究表明,可能的特异性预测指标包括年龄、癫痫发作类型、癫痫病因、癫痫综合征类型、认知与行为水平、头皮脑电图相关指标及心率变异性相关指标等,但因研究设计等因素的异质性,导致其中部分指标仍有争议。现根据相关文献资料进行分析、整理和归纳,综述迷走神经刺激术对难治性癫痫疗效的预测指标,希望为未来研究提供方向。

Vagus nerve stimulation is an effective treatment for drug-resistant epilepsy,and its efficacy and safety have been confirmed after over two decades of clinical practices.However,reassuring predictors to evaluate whether patients with drug-resistant epilepsy could gain benefit from vagus nerve stimulation has not been established,because the underlying mechanism remain poorly understood.Previous studies revealed that presumable patient-related predictors included age,epileptic seizure type,epilepsy etiology,epilepsy syndrome,cognitive and behavioral responsiveness,scalp electroencephalographic related signals and heart rate variability related signals.However,most of the predictors still remain controversial due to the factors such as the heterogeneity of different research design.This article aims at analyzing and concluding the information from relevant literatures,and summing up the predictors of efficacy before vagus nerve stimulation in refractory epilepsy to highlight the future work.