基于经颅磁刺激的神经可塑性治疗弱视

IF 2.7 4区医学 Q2 BIOCHEMICAL RESEARCH METHODS

Journal of Neuroscience Methods Pub Date : 2025-04-30 DOI:10.1016/j.jneumeth.2025.110464

Yilong Lin , Kaifang Cai

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引用次数: 0

摘要

近年来，重复性经颅磁刺激（rTMS）通过调节皮层神经活动，特别是视觉相关脑区的功能连通性，在改善神经可塑性方面显示出积极的临床效果。本研究旨在探讨rTMS对成人弱视视功能的影响，并利用静息状态功能磁共振成像（rs-fMRI）评估治疗前后脑神经元活动的变化。新方法将148例屈光参差性弱视患者随机分为人工晶状体（ICL）组和ICL+rTMS组，每组74例。所有患者均接受了详细的围手术期护理。治疗前和治疗后3个月采用视觉感知测试系统评估最佳矫正视力（BCVA）和随机点立体视，并采用rs-fMRI评估脑功能状态。结果与治疗前相比，ICL组和ICL+rTMS组治疗3个月后BCVA和随机点立体视均有明显改善，ICL+rTMS组疗效优于ICL组（P <； 0.05）。rs-fMRI显示出明显的神经可塑性模式：ICL组同侧额叶ALFF升高，ICL+rTMS组同侧小脑ALFF降低（P <； 0.05）。与单用ICL相比，rTMS联合ICL可显著降低同侧额叶和额上回的ReHo，降低对侧颞叶的fALFF，增加对侧枕叶的fALFF （P <； 0.05）。与现有方法的比较应用rTMS直接调控神经可塑性提供了一种无创、精准的治疗方法。与传统疗法相比，rTMS能更有效地促进弱视患者视皮层功能重组，提高治疗效果，且副作用少，具有较高的临床应用潜力。结论rtms可通过调节神经元活动，增强视皮层神经可塑性，纠正眼间兴奋差异，有效改善成人弱视患者的视功能，发挥治疗作用。

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Transcranial magnetic stimulation-based neuroplasticity in the treatment of amblyopia

Background

In recent years, repetitive transcranial magnetic stimulation (rTMS) has shown positive clinical effects in improving neuroplasticity by modulating cortical neural activity, particularly the functional connectivity of visual-related brain regions. This research was aimed to investigate the effects of rTMS on visual function in adult amblyopia and to assess changes in brain neuronal activity before and following remedy using resting-state functional magnetic resonance imaging (rs-fMRI).

New Method

A total of 148 patients with anisometropic amblyopia were enrolled and randomly divided into: intraocular lens (ICL) group and ICL+rTMS group, with 74 cases in each group. All patients received detailed perioperative care. Best-corrected visual acuity (BCVA) and random dot stereopsis were assessed using the Vision Perception Test System before treatment and 3 months following remedy, and brain functional status was evaluated using rs-fMRI.

Results

As against pre-treatment levels, both ICL group and ICL+rTMS group suggested visible improvements in BCVA and random dot stereopsis 3 months following remedy, with ICL+rTMS group exhibiting better outcomes than ICL group (P < 0.05). The rs-fMRI revealed distinct patterns of neural plasticity: ICL group exhibited an increase in the ALFF of the ipsilateral frontal lobe, while ICL+rTMS group showed a decrease in the ALFF of the same-side cerebellum (P < 0.05). Compared to ICL alone, the combination of rTMS and ICL significantly reduced the ReHo in the ipsilateral frontal lobe and superior frontal gyrus, decreased the fALFF in the contralateral temporal lobe, and increased the fALFF in the contralateral occipital lobe (P < 0.05).

Comparison with Existing Methods

The application of rTMS to directly regulate neural plasticity provides a non-invasive and precise treatment method. Compared with traditional therapies, rTMS can more effectively promote the reorganization of visual cortex function in amblyopia patients, improve treatment efficacy, and have fewer side effects, thus having high clinical application potential.

Conclusion

rTMS can effectively improve visual function in adult amblyopia patients by modulating neuronal activity and enhancing visual cortical neuroplasticity to correct the interocular excitation differences and exert therapeutic effects.

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来源期刊

Journal of Neuroscience Methods 医学-神经科学

CiteScore

7.10

自引率

3.30%

发文量

226

审稿时长

52 days

期刊介绍： The Journal of Neuroscience Methods publishes papers that describe new methods that are specifically for neuroscience research conducted in invertebrates, vertebrates or in man. Major methodological improvements or important refinements of established neuroscience methods are also considered for publication. The Journal''s Scope includes all aspects of contemporary neuroscience research, including anatomical, behavioural, biochemical, cellular, computational, molecular, invasive and non-invasive imaging, optogenetic, and physiological research investigations.