Noninvasive Brain Stimulation Protocols in the Treatment of Epilepsy: Current State and Perspectives
Noninvasive Brain Stimulation Protocols in the Treatment of Epilepsy: Current State and Perspectives
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DOI：
10.1016/j.nurt.2009.01.003
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发表时间：
2009-04-01
影响因子：
5.7
通讯作者：
Paulus, Walter
中科院分区：
文献类型：
--
作者：
Nitsche, Michael A.;Paulus, Walter
在癫痫发作时，由阵发性去极化转变引发的神经元网络高频同步放电的可能性增加。降低神经元兴奋性是抗癫痫治疗的常见目标。除了药物干预之外，降低兴奋性的大脑刺激也被视为一种替代治疗方法。因此，非侵入性脑刺激工具，例如经颅磁刺激（TMS）和经颅直流电刺激（tDCS），作为调节皮质兴奋性和活动的有效工具越来越受到人们的关注。在动物模型中，刺激引起的皮质兴奋性降低已被证明适合减少癫痫发作。然而，迄今为止进行的临床研究显示出不同的结果。将讨论其原因以及可能导致未来更有效的刺激方案的可能优化策略。
In epileptic seizures, there is an enhanced probability of neuronal networks to fire synchronously at high frequency, initiated by a paroxysmal depolarisation shift. Reducing neuronal excitability is a common target of anti-epileptic therapies. Beyond or in addition to pharmacological interventions, excitability-reducing brain stimulation is pursued as an alternative therapeutic approach. Hereby, non-invasive brain stimulation tools, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), have gained increased interest as efficient tools to modulate cortical excitability and activity. In animal models, stimulation-induced cortical excitability diminution has been shown to be suited to reduce seizures. Clinical studies conducted to date, however, have shown mixed results. Reasons for this, as well as possible optimization strategies that might lead to more efficient future stimulation protocols, will be discussed.