中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2025, Vol. 20 ›› Issue (4): 917-935.doi: 10.4103/NRR.NRR-D-23-01444

• 综述:脑损伤修复保护与再生 •    下一篇

癫痫的发病机制、检测和治疗：电磁介导的神经调控疗法及新技术研究

  

  • 出版日期:2025-04-15 发布日期:2024-06-30

Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation–mediated neuromodulation therapy and new technologies

Dian Jiao1 , Lai Xu1 , Zhen Gu2 , Hua Yan1 , Dingding Shen3, *, Xiaosong Gu1, *   

  1. 1 Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China; 2 Key Laboratory of Advanced Drug Delivery Systems of Zhejiang Province, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, Zhejiang Province, China; 3 Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
  • Online:2025-04-15 Published:2024-06-30
  • Contact: Xiaosong Gu, PhD, nervegu@ntu.edu.cn; Dingding Shen, PhD, dds@ntu.edu.cn.
  • Supported by:
    The work was supported by the National Natural Science Foundation of China, No. 32130060 (to XG)

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摘要：

癫痫是一种严重的且反复发作的多因素的神经系统疾病。对于癫痫的准确诊断和治疗需要对其发病机制有全面的了解。研究表明，癫痫的发病机制复杂，涉及基因表达、蛋白质表达、离子通道表达、能量代谢产物、肠道微环境等变量的变化。传统的治疗方法根治癫痫仍然很难实现。为解决癫痫引起的疼痛，临床上主要采用手术切除病灶、药物治疗和非药物治疗。其中生酮饮食、神经再生基因治疗和神经调控等非药物治疗是目前研究和应用的重点。因此，此次综述对癫痫的发病机制、诊断方法和治疗进行了全面的总结，并详细阐述了神经疗法中侵入性神经刺激，包括经皮迷走神经刺激、深部脑电刺激和重复神经电刺激，以及非侵入性经颅磁刺激和经颅直流电刺激的理论基础、治疗模式和效果。大量研究表明，电磁介导的神经调控疗法能够显著改善神经系统功能，减少癫痫发作次数。此外，大量诊断和治疗癫痫的新技术也在逐渐探索之中。但是目前的研究主要集中在通过分析患者的临床表现和探索相关的诊断和治疗方法来研究分子水平的发病机制，对疾病相关的发病机制缺乏共识是一个重大挑战。

https://orcid.org/0000-0002-2562-6275 (Xiaosong Gu)

关键词: 癫痫, 发病机制, 癫痫监测, 脑电图, 诊断, 药物干预, 非药物干预, 神经刺激, 神经再生, 预测

Abstract: Epilepsy is a severe, relapsing, and multifactorial neurological disorder. Studies regarding the accurate diagnosis, prognosis, and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy. The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression, protein expression, ion channel activity, energy metabolites, and gut microbiota composition. Satisfactory results are lacking for conventional treatments for epilepsy. Surgical resection of lesions, drug therapy, and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy. Non-pharmacological treatments, such as a ketogenic diet, gene therapy for nerve regeneration, and neural regulation, are currently areas of research focus. This review provides a comprehensive overview of the pathogenesis, diagnostic methods, and treatments of epilepsy. It also elaborates on the theoretical basis, treatment modes, and effects of invasive nerve stimulation in neurotherapy, including percutaneous vagus nerve stimulation, deep brain electrical stimulation, repetitive nerve electrical stimulation, in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation. Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures. Additionally, many new technologies for the diagnosis and treatment of epilepsy are being explored. However, current research is mainly focused on analyzing patients’ clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level, which has led to a lack of consensus regarding the mechanisms related to the disease.

Key words: diagnosis, drug treatment, electroencephalography, epilepsy monitoring, epilepsy, nerve regeneration, neurostimulation, non-drug interventions, pathogenesis, prediction