Safety of noninvasive brain stimulation in children and adolescents.
Safety of noninvasive brain stimulation in children and adolescents.
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DOI：
10.1016/j.brs.2014.10.012
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发表时间：
2015-01
影响因子：
7.7
通讯作者：
Ehinger M
中科院分区：
文献类型：
--
作者：
Krishnan C;Santos L;Peterson MD;Ehinger M
无创脑刺激(NIB)技术，如经颅磁刺激(TMS)和经颅电流刺激(TCS)，有可能缓解与神经和精神疾病相关的各种症状，包括中风、脑瘫、自闭症、抑郁症和多发性抽动症。虽然这些方法在成人中的安全性已经得到证实，但评估NIBS在儿童中的安全性的研究很少。研究现有文献中有关NIBS技术在患有神经和神经精神障碍的儿童和青少年中的安全性。在网上数据库上进行电子搜索，寻找使用NIB的研究对象，研究对象为18岁以下的个人。排除非英文出版物、诊断性研究、电休克治疗、单/双脉冲TMS研究和综述。研究中报告的不良事件经过仔细检查和综合，以了解儿童和青少年中NIBs的安全性和耐受性。对513名儿童/青少年(2.5-17.8岁)的48项研究的数据表明，NIBS的副作用总体上是轻微和短暂的[TMS：头痛(11.5%)、头皮不适(2.5%)、抽搐(1.2%)、情绪变化(1.2%)、疲劳(0.9%)、耳鸣(0.6%)；TCS：刺痛(11.5%)、瘙痒(5.8%)、发红(4.7%)、头皮不适(3.1%)]严重不良反应相对较少。我们的研究结果表明，对于患有各种神经系统疾病的儿童和青少年，重复TMS和TCS都是安全的方法，特别是在遵循安全指南的情况下。不良事件的发生率似乎与在成人中观察到的相似；然而，需要进行更长治疗和随访期的进一步研究，以更好地了解长期使用NIB对儿童的益处和耐受性。
Noninvasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation (TMS) and transcranial current stimulation (tCS) have the potential to mitigate a variety of symptoms associated with neurological and psychiatric conditions, including stroke, cerebral palsy, autism, depression, and Tourette syndrome. While the safety of these modalities has been established in adults, there is a paucity of research assessing the safety of NIBS among children. To examine the existing literature regarding the safety of NIBS techniques in children and adolescents with neurologic and neuropsychiatric disorders. An electronic search was performed on online databases for studies using NIBS in individuals less than 18 years of age. Non-English publications, diagnostic studies, electroconvulsive therapy, single/dual pulse TMS studies, and reviews were excluded. Adverse events reported in the studies were carefully examined and synthesized to understand the safety and tolerability of NIBS among children and adolescents. The data from 48 studies involving more than 513 children/adolescents (2.5–17.8 years of age) indicate that the side-effects of NIBS were, in general, mild and transient [TMS: headache (11.5%), scalp discomfort (2.5%), twitching (1.2%), mood changes (1.2%), fatigue (0.9%), tinnitus (0.6%); tCS: tingling (11.5%), itching (5.8%), redness (4.7%), scalp discomfort (3.1%)] with relatively few serious adverse events. Our findings indicate that both repetitive TMS and tCS are safe modalities in children and adolescents with various neurological conditions, especially when safety guidelines are followed. The incidence of adverse events appears to be similar to that observed in adults; however, further studies with longer treatment and follow-up periods are needed to better understand the benefits and tolerance of long-term use of NIBS in children.
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影响因子：
3.1
作者：
Collange Grecco, Luanda Andre;Carvalho Duarte, Natalia de Almeida;Oliveira, Claudia Santos
通讯作者：
Oliveira, Claudia Santos
影响因子：
2.5
作者：
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通讯作者：
Levkovitz, Yechiel
影响因子：
2.9
作者：
Figiel, GS;Epstein, C;Glover, S
通讯作者：
Glover, S
影响因子：
1.9
作者：
Andrade, Agnes Carvalho;Magnavita, Guilherme Moreira;Fregni, Felipe
通讯作者：
Fregni, Felipe
影响因子：
4.7
作者：
Fregni, F;Boggio, PS;Valente, K
通讯作者：
Valente, K