Pediatric Deep Brain Stimulation for Dystonia: Current State and Ethical Considerations.
Pediatric Deep Brain Stimulation for Dystonia: Current State and Ethical Considerations.
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DOI：
10.1017/s0963180120000316
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发表时间：
2020-10
影响因子：
1.8
通讯作者：
Lazaro-Munoz, Gabriel
中科院分区：
文献类型：
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作者：
Munoz, Katrina A.;Blumenthal-Barby, Jennifer;Storch, Eric A.;Torgerson, Laura;Lazaro-Munoz, Gabriel
肌张力障碍是一种运动障碍，可能对运动功能和生活质量产生破坏性影响。美国有 250,000 例病例，大多数在儿童时期发病。由于现有治疗方法的有效性和副作用有限，小儿深部脑刺激（pDBS）已成为治疗难治性肌张力障碍的一种干预措施。然而，该临床实践领域的临床和神经伦理学研究有限。本文探讨了向难治性肌张力障碍儿童提供 pDBS 是否在伦理上合理。鉴于有利的风险收益状况，得出的结论是，对于肌张力障碍的某些病因提供 pDBS 在伦理上是合理的，但对于其他病因则不太清楚。此外，还讨论了各种伦理和政策问题，需要解决这些问题以优化为肌张力障碍提供 pDBS 的实践。随着 pDBS 的不断扩张，提出了一些策略来帮助解决这些问题。
Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the US, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation (pDBS) has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS to children with refractory dystonia. Given the favorable risk-benefit profile, it is concluded that offering pDBS is ethically justified for certain etiologies of dystonia, but it is less clear for others. In addition, various ethical and policy concerns are discussed, which need to be addressed to optimize the practice of offering pDBS for dystonia. Strategies are proposed to help address these concerns as pDBS continues to expand.