解码病毒后疲劳:基底神经节在长期慢性乙型肝炎中的复杂作用

IF 3.2 Q2 CLINICAL NEUROLOGY
T. Rudroff
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引用次数: 0

摘要

长期慢性阻塞性肺气肿给数百万人带来了无尽的疲劳,扰乱了日常生活。这篇叙述性综述旨在综合基底神经节在长期慢性阻塞性脑损伤性疲劳中作用的现有证据,讨论潜在的机制,并强调有前景的治疗干预措施。我们使用 PubMed、Scopus 和 Web of Science 数据库进行了全面的文献检索。正电子发射计算机断层显像(PET)、核磁共振成像(MRI)和功能连接数据显示,基底神经节在长期COVID疲劳中出现紊乱,包括炎症、新陈代谢紊乱、体积变化和网络改变,主要集中在调节动机的纹状体多巴胺回路。理论认为,炎症引起的信号紊乱可能会阻碍努力/回报评估,破坏皮层-皮层下的动机通路,或减少对唤醒中枢的兴奋性输入,从而削弱驱动力的启动。最近针对基底神经节异常的治疗试验显示出暂时的疗效。然而,不同的结果、不一致的衡量标准,以及感知疲劳与客观疲劳之间的差异,都影响了研究的深入。尽管研究日益增多,但在了解基底节功能障碍与疲劳之间的确切联系途径以及验证治疗效果方面仍存在差距。要进一步了解基底神经节对长期慢性阻塞性脑损伤神经系统后遗症的影响,并为不断扩大的受影响人群提供改善功能的希望,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Decoding Post-Viral Fatigue: The Basal Ganglia’s Complex Role in Long-COVID
Long-COVID afflicts millions with relentless fatigue, disrupting daily life. The objective of this narrative review is to synthesize current evidence on the role of the basal ganglia in long-COVID fatigue, discuss potential mechanisms, and highlight promising therapeutic interventions. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases. Mounting evidence from PET, MRI, and functional connectivity data reveals basal ganglia disturbances in long-COVID exhaustion, including inflammation, metabolic disruption, volume changes, and network alterations focused on striatal dopamine circuitry regulating motivation. Theories suggest inflammation-induced signaling disturbances could impede effort/reward valuation, disrupt cortical–subcortical motivational pathways, or diminish excitatory input to arousal centers, attenuating drive initiation. Recent therapeutic pilots targeting basal ganglia abnormalities show provisional efficacy. However, heterogeneous outcomes, inconsistent metrics, and perceived versus objective fatigue discrepancies temper insights. Despite the growing research, gaps remain in understanding the precise pathways linking basal ganglia dysfunction to fatigue and validating treatment efficacy. Further research is needed to advance understanding of the basal ganglia’s contribution to long-COVID neurological sequelae and offer hope for improving function across the expanding affected population.
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来源期刊
Neurology International
Neurology International CLINICAL NEUROLOGY-
CiteScore
3.70
自引率
3.30%
发文量
69
审稿时长
11 weeks
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