经颅颞叶干扰刺激的人体应用:系统综述。

Ilya Demchenko, Ishaan Tailor, Sina Chegini, Haochen Yu, Fatemeh Gholamali Nezhad, Alice Rueda, Anne Kever, Sridhar Krishnan, Abhishek Datta, Jed A Meltzer, Simon J Graham, Tom A Schweizer, Sumientra Rampersad, Edward S Boyden, Ines R Violante, Robert Chen, Andres M Lozano, Venkat Bhat
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引用次数: 0

摘要

背景:许多神经和精神疾病涉及皮质下结构的失调。经颅颞叶干扰刺激(tTIS)是一种新的、非侵入性的方法,可以选择性地调节这些区域和相关的神经回路。方法:对tTIS (PROSPERO ID: CRD42024559678)的临床应用进行系统评价。MEDLINE, Embase, APA PsycINFO, CENTRAL, ClinicalTrials.gov和WHO ICTRP被检索到2024年12月12日。涉及tTIS人体应用的研究是合格的。采用美国国立卫生研究院和改良的牛津循证医学中心工具对方法学质量进行评价。结果:回顾了48项记录(20项已发表的研究,28项正在进行的试验)。在已发表的研究中,有16项单期研究和4项多期研究评估了820名参与者的tTIS的安全性、机制结局或治疗效果。刺激最常见的是在β(20赫兹)或γ(30-130赫兹)包络频率下进行。神经影像学研究支持人类运动皮层、基底神经节和海马体的目标参与,特别是当刺激与行为任务配对时。在小样本中的初步临床结果显示,帕金森病和原发性震颤患者在单次tTIS治疗后60分钟内,运动迟缓和震颤的急性症状得到改善。所有研究报告的不良事件都是轻微的(例如,刺痛,瘙痒)。新兴试验越来越多地采用多期治疗方案(2-40期),并将tTIS扩展到神经和精神疾病患者,特别是癫痫和抑郁症患者。结论:i期研究表明,tTIS是安全的,耐受性良好,并且可以作用于人类深部脑靶点。需要进行控制良好的2期试验来评估其在患者群体中的治疗潜力。20项研究表明,在健康和临床队列中,tTIS是安全且耐受性良好的。一次tTIS治疗可在1小时内改善帕金森病患者的运动迟缓和震颤。多期试验目前正在测试tTIS在癫痫、抑郁症和其他疾病中的疗效。需要进行强有力的2期试验来研究tTIS在患者群体中的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Human Applications of Transcranial Temporal Interference Stimulation: A Systematic Review.

Background: Many neurological and psychiatric disorders involve dysregulation of subcortical structures. Transcranial temporal interference stimulation (tTIS) is a novel, non-invasive method developed to selectively modulate these regions and associated neural circuits.

Methods: A systematic review was conducted to evaluate human applications of tTIS (PROSPERO ID: CRD42024559678). MEDLINE, Embase, APA PsycINFO, CENTRAL, ClinicalTrials.gov , and WHO ICTRP were searched up to December 12, 2024. Studies involving human applications of tTIS were eligible. Methodological quality was appraised using the NIH and modified Oxford Centre for Evidence-Based Medicine tools.

Results: Forty-eight records were reviewed (20 published studies, 28 ongoing trials). Of published studies, 16 single-session and 4 multi-session studies assessed safety, mechanistic outcomes, or therapeutic effects of tTIS in 820 participants. Stimulation was most commonly delivered at beta (20 Hz) or gamma (30-130 Hz) envelope frequencies. Neuroimaging studies support target engagement of the motor cortex, basal ganglia, and hippocampus in humans, particularly when stimulation is paired with behavioural tasks. Preliminary clinical findings in small samples demonstrated acute symptom improvements in bradykinesia and tremor within 60 minutes following a single tTIS session in Parkinson's disease and essential tremor. Reported adverse events across studies were mild (e.g., tingling, itching). Emerging trials increasingly utilize multi-session protocols (2-40 sessions) and are extending tTIS to patients with neurological and psychiatric disorders, particularly epilepsy and depression.

Conclusions: Phase 1 studies demonstrate that tTIS is safe, well-tolerated, and can engage deep brain targets in humans. Well-controlled Phase 2 trials are needed to assess its therapeutic potential in patient populations.

Highlights: tTIS engages the motor cortex, basal ganglia, and hippocampus across human studies20 studies show tTIS is safe and well-tolerated in healthy and clinical cohortsOne tTIS session improves bradykinesia and tremor in Parkinsonism within 1 hourMulti-session trials now test tTIS in epilepsy, depression, and other disordersRobust Phase 2 trials are needed to study the efficacy of tTIS in patient populations.

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