中国全科医学 ›› 2025, Vol. 28 ›› Issue (34): 4258-4281.DOI: 10.12114/j.issn.1007-9572.2025.0298

• 指南·共识 • 上一篇    下一篇

老年失能失智非侵入性神经调控的效应和疗效评价的专家共识

国家重点研发计划《多类型物理刺激方式对机体功能的影响与机理研究》项目专家组, 中国康复医学会脑功能监测与调控康复专业委员会, 北京神经内科学会脑小血管病专业委员会   

  • 收稿日期:2025-09-10 修回日期:2025-09-23 出版日期:2025-12-05 发布日期:2025-10-21
  • 基金资助:
    国家重点研发计划(2022YFC3600504)

Expert Consensus on the Effects and Efficacy Evaluation of Non-invasive Neuromodulation in Elders with Disability and Dementia

Expert Panel of the National Key R&D Program "Research on the Effects and Mechanisms of Multiple Types of Physical Stimulation on Body Function", Brain Function Detection and Regulation Rehabilitation Professional Committee of Chinese Association of Rehabilitation Medicine, Cerebral Small Vessel Disease Professional Committee of Beijing Neurology Association   

  • Received:2025-09-10 Revised:2025-09-23 Published:2025-12-05 Online:2025-10-21

摘要: 随着全球老龄化进程的加速,神经退行性疾病的负担日益加重,给社会和家庭带来了沉重的经济和护理压力。非侵入性神经调控(NINM)作为潜在的解决方案,尽管在延缓功能衰退中展现出独特优势,但其效应和疗效评价仍缺乏科学、全面、标准化的体系。目前的评价方法多依赖主观量表,忽略了脑功能的动态变化,且安全性阈值模糊,难以全面评估技术的长期疗效和临床获益。基于循证医学证据、国内外指南与专家共识以及现有临床实践经验和技术管理规范,本共识针对老年失能失智人群制定了11项NINM干预共识意见。这些意见系统地涵盖了人群选择、干预策略、疗效与效应评估指标及安全监管等多个关键方面。本共识的制定旨在提升临床应用的科学性与可行性,为老年失能失智人群的NINM干预提供规范化指导,确保其在临床实践中的合理应用和有效管理。

关键词: 认知障碍, 老年失能失智, 非侵入性神经调控, 效应和疗效评价

Abstract:

With the accelerating global aging population, the burden of neurodegenerative diseases continues to rise, placing substantial economic and caregiving pressure on both society and families. Non-invasive neuromodulation (NINM) has emerged as a potential intervention, demonstrating unique advantages in mitigating functional decline. However, a scientific, comprehensive, and standardized system is still lacking in the current evaluation of effects and efficacy, as they rely heavily on subjective scales, overlook the dynamic changes of brain function, and involve ambiguous safety thresholds, thereby constraining comprehensive assessment of the long-term efficacy and clinical benefits of NINM. Based on evidence-based medicine, domestic and international guidelines, expert consensus, clinical practical experience, and technical management standards, this consensus statement proposes 11 recommendations for NINM interventions targeting elderly individuals with disability and dementia. These recommendations systematically encompass key domains including patient selection, intervention strategies, efficacy and effectiveness evaluation, and safety monitoring. The development of this consensus aims to enhance the scientific rigor and feasibility of clinical application, providing standardized guidance for NINM interventions in elderly populations with disability and dementia, thus ensuring their rational implementation and effective management in clinical practice.

Key words: Cognition disorders, Elderly disability and dementia, Non-invasive neuromodulation, Efficacy and effectiveness evaluation