卒中预测与诊疗的数字孪生技术OA
Digital Twins for Stroke Prediction and Management
背景:卒中是全球主要的致死和致残原因,其最佳预后取决于对风险的快速识别、精准的急性期管理、个体化的干预措施以及持续的康复治疗.数字孪生(Digital twins)是一种创新方法,它通过整合多模态数据和机制模型,构建患者个体的动态计算副本,从而能够在真实世界实施前模拟疾病演变轨迹和治疗反应.目的:本叙述性综述旨在整合当前关于数字孪生在卒中诊疗全流程中应用的证据,探讨其在风险预测、急性期决策支持、临床试验优化、重症监护监测及个体化神经康复中的作用.方法:我们检索了2021年至2025年间PubMed、Nature Portfolio期刊、IEEE和ACM数据库的出版物,从技术、临床及实施层面筛选出相关文献.检索词将"数字孪生"与卒中特异性术语及赋能技术术语相结合.本综述综合了技术、临床及实施等多维度的发现,为这一快速发展的领域提供了全面的视角.结果:新兴证据表明,数字孪生在卒中的多个阶段均展现出可行性和早期临床应用价值.具体应用包括:通过患者特异性左心房建模对房颤相关栓塞风险进行分层、利用影像学数据驱动的脑血管血流动力学分析辅助急性期分诊、利用疾病数字孪生生成器优化临床试验入组,以及采用自适应学习的机器人康复系统.然而,大多数研究仍处于临床前或早期试点阶段,鲜有研究能满足数字孪生的严格实时标准,即要求双向数据流和持续更新.结论:数字孪生通过个体化风险评估、超急性期决策支持和自适应康复,为卒中诊疗带来了变革性的潜力.要将其转化为常规临床实践,尚需严格的前瞻性验证、标准化的数据模型、健全的治理框架,以及在多样化人群中证实的临床效用.制定清晰的转化路线图,从当前的组件技术迈向全闭环系统,对于指导投资和确定研究重点至关重要.
Background:Stroke remains a leading global cause of mortality and disability,with optimal outcomes dependent on rapid risk identification,precise acute management,tailored interventions,and sustained rehabilitation.Digital twins,which are dynamic computational replicas of individual patients integrating multimodal data and mechanistic models,represent an innovative approach to simulating disease trajectories and treatment responses before real world implementation.Objective:This narrative review synthesises current evidence on digital twin applications across the stroke care continuum,examining their role in risk prediction,acute decision support,clinical trial optimisation,intensive care monitoring,and personalised neurorehabilitation.Method:We explored publications from PubMed,Nature Portfolio journals,IEEE and ACM databases spanning 2021 to 2025,identifying relevant publications across technical,clinical,and implementation dimensions.Search terms combined"digital twin"with stroke-specific and enabling-technology terminology.The review integrates findings across technical,clinical,and implementation dimensions to provide a holistic perspective on this rapidly evolving field.Results:Emerging evidence demonstrates feasibility and early clinical utility of digital twins across multiple stroke phases.Applications include atrial fibrillation related embolic risk stratification through patient specific left atrial modelling,imaging informed cerebrovascular hemodynamics for acute triage,disease digital twin generators for trial enrichment,and robotic rehabilitation systems with adaptive learning.However,most studies remain at preclinical or early pilot stages,with few meeting strict real-time digital twin criteria requiring bidirectional data flow and continuous updating.Conclusion:Digital twins offer transformative potential for stroke care through personalised risk assessment,hyperacute decision support,and adaptive rehabilitation.Translation to routine practice requires rigorous prospective validation,standardised data models,robust governance frameworks,and demonstrated clinical utility across diverse populations.A clear translational roadmap,from current component technologies to fully closed-loop systems,is essential to guide investment and prioritise research.
David B.Olawade;唐颖馨
医药卫生
数字孪生卒中预测个性化医疗脑血管血流动力学神经康复精准医疗血流动力学神经康复
digital twinsstroke predictionpersonalised medicinecerebrovascular hemodynamicsneurological rehabilitationprecision medicinehemodynamicsneurorehabilitation
《神经损伤与功能重建》 2026 (6)
封3-封3,1
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