重复经颅磁刺激治疗阿尔茨海默病的神经生物学基础

IF 13 1区 医学 Q1 CLINICAL NEUROLOGY
Annibale Antonioni, Alessandro Martorana, Emiliano Santarnecchi, Harald Hampel, Giacomo Koch
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引用次数: 0

摘要

无创脑刺激(NIBS)技术,如重复经颅磁刺激(rTMS),是阿尔茨海默病(AD)的有希望的候选治疗方法。我们回顾了支持rTMS治疗AD的基本作用机制的证据。rTMS在不同的神经生物学和系统神经生理学水平上具有深远的影响。通过参与不同的突触前和突触后结构在受刺激的神经网络,它直接或间接地影响各种细胞和分子成分。在AD中,rTMS影响突触可塑性,在宏观水平上诱导持久的结构变化和功能和结构连接的广泛重组。重要的是,它通过靶向谷氨酸能和γ-氨基丁酸(GABA)能通路,调节AD中特指中断的神经递质回路,恢复兴奋/抑制平衡。此外,rTMS增加神经营养因子,抵消淀粉样蛋白和tau蛋白的积累,并通过减少小胶质细胞的激活和促炎细胞因子的释放来减轻神经炎症。因此,成熟的临床前证据可以指导未来基于个性化NIBS对AD患者的精准医学治疗策略。非侵入性脑刺激(NIBS)技术,如重复经颅磁刺激(rTMS),是治疗阿尔茨海默病(AD)的有希望的候选治疗方法。rTMS调节神经可塑性、神经传递和神经炎症。临床前研究显示rTMS在AD中的疾病特异性神经生物学效应。来自AD患者的有希望的数据表明动物模型结果的可翻译性。临床前数据可以通过个性化NIBS指导精准医疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The neurobiological foundation of effective repetitive transcranial magnetic brain stimulation in Alzheimer's disease

The neurobiological foundation of effective repetitive transcranial magnetic brain stimulation in Alzheimer's disease

Noninvasive brain stimulation (NIBS) techniques, such as repetitive transcranial magnetic stimulation (rTMS), are promising candidate therapeutics for Alzheimer's disease (AD). We review the evidence supporting the fundamental mechanisms of action of rTMS treatments in AD. rTMS exerts profound effects at different neurobiological and systems neurophysiological levels. By engaging distinct pre- and postsynaptic structures within the stimulated neural network, it directly or indirectly influences various cellular and molecular components. In AD, rTMS influences synaptic plasticity, inducing lasting structural changes and broad reorganization of functional and structural connectivity at the macroscale level. Importantly, it modulates neurotransmitter circuits characteristically disrupted in AD and restores the excitation/inhibition balance by targeting glutamatergic and γ-aminobutyric acid (GABA)ergic pathways. Moreover, rTMS increases neurotrophic factors, counteracts amyloid and tau accumulation, and mitigates neuroinflammation by reducing microglial activation and pro-inflammatory cytokines release. Therefore, maturing preclinical evidence could guide future precision medicine therapeutic strategies based on personalized NIBS in AD patients.

Highlights

  • Noninvasive brain stimulation (NIBS) techniques, such as repetitive transcranial magnetic stimulation (rTMS), are promising candidate therapeutics for Alzheimer's disease (AD).
  • rTMS modulates neuroplasticity, neurotransmission, and neuroinflammation.
  • Preclinical research shows disease-specific neurobiological effects of rTMS in AD.
  • Promising data from AD patients suggest the translatability of animal model results.
  • Preclinical data may guide precision medicine strategies through personalized NIBS.
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来源期刊
Alzheimer's & Dementia
Alzheimer's & Dementia 医学-临床神经学
CiteScore
14.50
自引率
5.00%
发文量
299
审稿时长
3 months
期刊介绍: Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.
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