A circuit view of deep brain stimulation in Alzheimer's disease and the possible mechanisms
A circuit view of deep brain stimulation in Alzheimer's disease and the possible mechanisms
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阿尔茨海默病深部脑刺激的回路视图及其可能机制
DOI：
10.1186/s13024-019-0334-4
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发表时间：
2019
影响因子：
15.1
通讯作者：
Han Yunyun
中科院分区：
文献类型：
--
作者：
Yu Danfang;Yan Huanhuan;Zhou Jun;Yang Xiaodan;Lu Youming;Han Yunyun
阿尔茨海默病（AD）的特征在于慢性进行性认知退化，经常伴有精神病理学症状，包括人格改变和社会孤立，这严重降低了生活质量。目前，没有可行的疗法或目前开发的用于治疗AD症状的药物能够减缓或逆转AD进展或预防神经变性的进展。因此，目前正在测试非药物替代品，包括脑深部电刺激（DBS）。DBS是一种用于多种神经和精神适应症（如运动障碍）的既定疗法。评估DBS治疗其他疾病的研究也发现了认知功能的改善，为DBS治疗AD的临床试验提供了动力。在AD临床试验和动物模型研究中，DBS的靶点包括穹窿、内嗅皮质（EC）、Meynert基底核（NBM）和斜角带垂直支（VDB）。然而，仍然没有全面的理论来解释DBS对AD症状的影响，也没有关于哪些靶点提供最佳益处的共识。本文综述了与AD相关的记忆回路的解剖结构，以及DBS在这些回路中挽救AD的研究和可能的治疗机制。
Alzheimer's disease (AD) is characterized by chronic progressive cognitive deterioration frequently accompanied by psychopathological symptoms, including changes in personality and social isolation, which severely reduce quality of life. Currently, no viable therapies or present-day drugs developed for the treatment of AD symptoms are able to slow or reverse AD progression or prevent the advance of neurodegeneration. As such, non-drug alternatives are currently being tested, including deep brain stimulation (DBS). DBS is an established therapy for several neurological and psychiatric indications, such as movement disorders. Studies assessing DBS for other disorders have also found improvements in cognitive function, providing the impetus for clinical trials on DBS for AD. Targets of DBS in AD clinical trials and animal model studies include the fornix, entorhinal cortex (EC), nucleus basalis of Meynert (NBM), and vertical limb of diagonal band (VDB). However, there is still no comprehensive theory explaining the effects of DBS on AD symptoms or a consensus on which targets provide optimal benefits. This article reviews the anatomy of memory circuits related to AD, as well as studies on DBS rescue of AD in these circuits and the possible therapeutic mechanisms.