Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases
Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases
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DOI：
10.1073/pnas.1405003111
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发表时间：
2014-10-14
影响因子：
11.1
通讯作者：
Pascual-Leone, Alvaro
中科院分区：
文献类型：
--
作者：
Fox, Michael D.;Buckner, Randy L.;Pascual-Leone, Alvaro
脑刺激是一种越来越多地用于神经和精神疾病的治疗方法，传统上分为侵入性方法，如脑深部电刺激（DBS）和非侵入性方法，如经颅磁刺激。这些方法之间的关系是未知的，治疗机制仍然不清楚，并且对于给定技术的理想刺激部位通常是模糊的，限制了刺激的优化及其在进一步疾病中的应用。在这篇文章中，我们确定了用两种类型的刺激治疗的疾病，列出了被认为在每种疾病中最有效的刺激部位，并测试了这些部位是由静息状态功能连接MRI定义的相同脑网络内的不同节点的假设。DBS有效的部位在功能上与非侵入性脑刺激在疾病中有效的部位相连，包括抑郁症、帕金森病、强迫症、特发性震颤、成瘾、疼痛、最低意识状态和阿尔茨海默病。缺乏功能连接的部位，刺激是无效的，相关性的迹象是否兴奋性或抑制性非侵入性刺激被发现临床有效。这些结果表明，静息状态功能连接可能有助于在刺激模式之间转换治疗，优化治疗和识别新的刺激靶点。更广泛地说，这项工作支持理解和治疗神经精神疾病的网络观点，突出了靶向脑网络调制的治疗潜力。
Brain stimulation, a therapy increasingly used for neurological and psychiatric disease, traditionally is divided into invasive approaches, such as deep brain stimulation (DBS), and noninvasive approaches, such as transcranial magnetic stimulation. The relationship between these approaches is unknown, therapeutic mechanisms remain unclear, and the ideal stimulation site for a given technique is often ambiguous, limiting optimization of the stimulation and its application in further disorders. In this article, we identify diseases treated with both types of stimulation, list the stimulation sites thought to be most effective in each disease, and test the hypothesis that these sites are different nodes within the same brain network as defined by resting-state functional-connectivity MRI. Sites where DBS was effective were functionally connected to sites where noninvasive brain stimulation was effective across diseases including depression, Parkinson's disease, obsessive-compulsive disorder, essential tremor, addiction, pain, minimally conscious states, and Alzheimer's disease. A lack of functional connectivity identified sites where stimulation was ineffective, and the sign of the correlation related to whether excitatory or inhibitory noninvasive stimulation was found clinically effective. These results suggest that resting-state functional connectivity may be useful for translating therapy between stimulation modalities, optimizing treatment, and identifying new stimulation targets. More broadly, this work supports a network perspective toward understanding and treating neuropsychiatric disease, highlighting the therapeutic potential of targeted brain network modulation.