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Spinal cord stimulation and deep brain stimulation for disorders of consciousness: a systematic review and individual patient data analysis of 608 cases

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Abstract

The application of spinal cord stimulation (SCS) and deep brain stimulation (DBS) for disorders of consciousness (DoC) has been increasingly reported. However, there is no sufficient evidence to determine how effective and safe SCS and DBS are for DoC owing to various methodological limitations. We conducted a systematic review to elucidate the safety and efficacy of SCS and DBS for DoC by systematically reviewing related literature by searching PubMed, EMBASE, Medline, and Cochrane Library. Twenty eligible studies with 608 patients were included in this study. Ten studies with 508 patients reported the efficacy of SCS for DoC, and the estimated overall effectiveness rate was 37%. Five studies with 343 patients reported the efficacy of SCS for VS, and the estimated effectiveness rate was 30%. Three studies with 53 patients reported the efficacy of SCS for MCS, and the estimated effectiveness rate was 63%. Five studies with 92 patients reported the efficacy of DBS for DoC, and the estimated overall effectiveness rate was 40%. Four studies with 63 patients reported the efficacy of DBS for VS, and the estimated effectiveness rate was 26%. Three studies with 19 patients reported the efficacy of DBS for MCS, and the estimated effectiveness rate was 74%. The adverse event rate of DoC was 8.1% and 18.2% after SCS and DBS, respectively. These results suggest that SCS and DBS can be considered reasonable treatments for DoC with considerable efficacy and safety.

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Funding

This work has been supported by grants from Clinical Research Incubation Project, West China Hospital, Sichuan University (2022HXFH024).

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Author notes

  1. Yang Wu, Yang-yang Xu, and Hao Deng contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, Sichuan Province, China

    Yang Wu, Yang-yang Xu, Hao Deng, Wei Zhang, Jia-ming Li, Bo-tao Xiong, Ling-long Xiao, Deng-hui Li, Rui-qing Yang & Wei Wang

  2. Department of Histoembryology and Neurobiology, West China College of Basic Medicine and Forensic Medicine, Sichuan University, Chengdu, Sichuan Province, China

    Shu-xin Zhang, Zhi-yi Ren & Yi-fan Qin

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  1. Yang Wu
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Contributions

Yang Wu, Yang-yang Xu, and Wei Wang proposed the conception and designed of the study. Yang Wu, Yang-yang Xu, and Hao Deng conducted the literature search and study screening. Yang Wu, Yang-yang Xu, Wei Zhang, Shu-xing Zhang, Jia-ming Li, and Bo-tao Xiong conducted data extraction and the quality assessment. Yang Wu, Hao Deng, Shu-xing Zhang, Ling-long Xiao, Deng-hui Li, Zhi-yi Ren, Yi-fan Qin, and Rui-qing Yang were involved in the analysis and interpretation of data. Yang Wu wrote the first draft of the manuscript and all authors revised it under the guidance of Wei Wang. Yang Wu, Yang-yang Xu, and Hao Deng conducted the manuscript revision.

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Correspondence to Wei Wang.

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Wu, Y., Xu, Yy., Deng, H. et al. Spinal cord stimulation and deep brain stimulation for disorders of consciousness: a systematic review and individual patient data analysis of 608 cases. Neurosurg Rev 46, 200 (2023). https://doi.org/10.1007/s10143-023-02105-1

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