Biomarker-guided neuromodulation aids memory in traumatic brain injury
Biomarker-guided neuromodulation aids memory in traumatic brain injury
复制标题
生物标记引导的神经调节有助于创伤性脑损伤的记忆
DOI：
10.1016/j.brs.2023.07.002
复制
发表时间：
2021
影响因子：
7.7
通讯作者：
R. Diaz
中科院分区：
文献类型：
--
作者：
M. Kahana;P. Wanda;Youssef Ezzyat;E. Solomon;Richard Adamovich;B. Lega;B. Jobst;Robert E. Gross;Kan Ding;R. Diaz
创伤性脑损伤（TBI）是成年人认知障碍的主要原因，通常以情节记忆和执行功能的明显缺陷为特征。先前的研究发现，颞叶皮层的直接电刺激可以改善癫痫患者的记忆力，但尚不清楚这些结果是否适用于具有特定TBI病史的患者。在这里，我们询问是否应用闭环，直接电刺激外侧颞叶皮层可以可靠地提高记忆在TBI队列。在接受难治性癫痫神经外科评估的较大患者组中，我们招募了一部分有中重度TBI病史的患者。通过分析患者学习和回忆单词列表时留置电极的神经数据，我们训练了个性化的机器学习分类器来预测每位患者记忆功能的瞬时波动。随后，我们使用这些分类器在预测记忆失败的时刻触发外侧颞叶皮层（LTC）的高频刺激。这种策略产生了19%的刺激与非刺激列表相比，召回性能的提升（P= 0.012）。这些结果为使用脑的闭环刺激治疗TBI相关的记忆障碍提供了概念验证。
Traumatic brain injury (TBI) is a leading cause of cognitive disability in adults, often characterized by marked deficits in episodic memory and executive function. Prior studies have found that direct electrical stimulation of the temporal cortex yielded improved memory in epilepsy patients, but it is not clear if these results generalize to patients with a specific history of TBI. Here we asked whether applying closed-loop, direct electrical stimulation to lateral temporal cortex could reliably improve memory in a TBI cohort. Among a larger group of patients undergoing neurosurgical evaluation for refractory epilepsy, we recruited a subset of patients with a history of moderate-to-severe TBI. By analyzing neural data from indwelling electrodes as patients studied and recalled lists of words, we trained personalized machine-learning classifiers to predict momentary fluctuations in mnemonic function in each patient. We subsequently used these classifiers to trigger high-frequency stimulation of the lateral temporal cortex (LTC) at moments when memory was predicted to fail. This strategy yielded a 19% boost in recall performance on stimulated as compared with non-stimulated lists (P= 0.012). These results provide a proof-of-concept for using closed-loop stimulation of the brain in treatment of TBI-related memory impairment.
DOI：
10.1056/nejmoa1107212
发表时间：
2012-02-09
期刊：
The New England journal of medicine
影响因子：
--
作者：
Suthana N;Haneef Z;Stern J;Mukamel R;Behnke E;Knowlton B;Fried I
通讯作者：
Fried I
影响因子：
3.7
作者：
Fischl, B;van der Kouwe, A;Dale, AM
通讯作者：
Dale, AM