Mal de debarquement syndrome: new insights
Mal de debarquement syndrome: new insights
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DOI：
10.1111/nyas.12701
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发表时间：
2015-01-01
期刊：
影响因子：
--
通讯作者：
Cha, Yoon-Hee
中科院分区：
文献类型：
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作者：
Cha, Yoon-Hee
Mal de Debarquement综合征（MdDS）是一种神秘的神经耳病学疾病，具有高发病率，心理社会负担和很少的治疗选择。幸运的是，最近在理解MDDS的生物学基础和治疗MDDS方面的科学兴趣有所增长。最近使用功能性神经影像学的研究表明，在持续性MdDS受试者的前额叶和颞叶皮质代谢降低的情况下，左内嗅皮质（EC）和杏仁核的葡萄糖代谢增加。EC是处理和门控存储在海马体中的空间信息的关键参与者，并且是脑振荡的主要驱动力。边缘系统集中也可能是有焦虑或慢性压力史的个体发生自发性MdDS样症状的关键。在背外侧前额叶皮层上进行重复经颅磁刺激治疗可以减少MdDS的摇晃头晕，成功的反应与顶叶和枕叶节点之间的脑网络的一致性降低有关。提出了一种新的理论MdDS的病理继发于夹带的内在脑网络驱动的振荡运动曝光加上无法随后desperizize这些节点的活动。未来的治疗策略可能是针对unyoking这些网络。
Mal de Debarquement Syndrome (MdDS) is an enigmatic neurotological disorder with high morbidity, psychosocial burden, and few treatment options. Fortunately, there has been recent growth in scientific interest in understanding the biological basis of and in treating MdDS. Recent studies using functional neuroimaging have shown increased glucose metabolism in the left entorhinal cortex (EC) and amygdala in the setting of decreased prefrontal and temporal cortex metabolism in subjects with persistent MdDS. The EC is a key player in processing and gating spatial information to be stored in the hippocampus and is a major driver of brain oscillations. A limbic focus may also be key to spontaneous MdDS-like symptoms occurring in individuals with a history of anxiety or chronic stress. Treatment with repetitive transcranial magnetic stimulation over the dorsolateral prefrontal cortex can decrease the rocking dizziness of MdDS, with successful responses associated with decreases in the coherence between brain networks with nodes in the parietal and occipital lobes. A new theory of MdDS is proposed as pathology secondary to entrainment of intrinsic brain networks driven by oscillatory motion exposure coupled with an inability to subsequently desynchronize the activity of these nodes. Future treatment strategies may be directed toward unyoking these networks.