摘要：

癫痫是常见的慢性神经系统疾病，约1/3最终诊断为难治性癫痫，传统药物和手术治疗效果有限，反应性神经电刺激作为一种闭环神经调控技术，为难治性癫痫患者提供新的治疗选择。反应性神经电刺激通过植入式电极实时监测脑电活动，识别癫痫发作前兆并进行电刺激干预，有效减少癫痫发作频率和强度。本文综述反应性神经电刺激的组成、刺激参数选择与动态调整、长期数据记录与分析、与机器学习算法的融合、临床应用进展及其与迷走神经刺激术的比较，探讨其面临的技术挑战并展望未来发展方向，以为更多难治性癫痫患者提供精准的个性化治疗并扩展至其他神经系统疾病的治疗中。

关键词: 耐药性癫痫, 电刺激疗法, 迷走神经刺激术, 综述

Abstract:

Epilepsy is a common chronic neurological disorder that severely impacts the quality of life and social functioning. Approximately 1/3 of patients are diagnosed with drug-resistant epilepsy (DRE), for which conventional antiepileptic seizure medicine (ASM) and traditional surgery have limited efficacy. In recent years, responsive neurostimulation (RNS), as a closed-loop neuromodulation technique, has provided a novel treatment option for DRE. The RNS utilizes invasived electrodes to monitor brain activity in real time, detect seizure precursors, and deliver electrical stimulation, effectively reducing the frequency and severity of DRE. This paper aims to review the composition of the RNS, optimization and dyanmic adjustment of stimulation parameters, long-term data recording and analysis, fusion with machine learning, clinical efficacy, and comparison with vagus nerve stimulation (VNS). It also explores the technical challenges and discusses future development directions. RNS holds promise for providing personalized and precise treatment to more DRE and expanding its application to other neurological disorders.

Key words: Drug resistant epilepsy, Electric stimulation therapy, Vagus nerve stimulation, Review