Noninvasive brain stimulation in Alzheimer's disease: systematic review and perspectives for the future.
Noninvasive brain stimulation in Alzheimer's disease: systematic review and perspectives for the future.
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DOI：
10.1016/j.exger.2011.04.001
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发表时间：
2011-08
影响因子：
3.9
通讯作者：
Pascual-Leone, Alvaro
中科院分区：
文献类型：
--
作者：
Freitas, Catarina;Mondragon-Llorca, Helena;Pascual-Leone, Alvaro
关键词：
许多研究已应用经颅磁刺激 (TMS) 来表征阿尔茨海默病 (AD) 的生理特征并监测药物的作用，而其他研究已开始使用经颅磁刺激 (TMS) 和经颅直流电刺激 (tDCS) 来改善 AD 的认知功能。这些应用程序仍处于开发早期，但为未来的开发提供了学习的机会。我们对所有使用非侵入性刺激治疗 AD 的研究进行了系统检索，并回顾了所有 29 篇已确定的文章。 24 项研究重点关注运动皮质反应性、（局部）可塑性和功能连接性的测量，其中 8 项研究还评估了药物的作用。五项研究重点关注 AD 患者认知功能的增强。与健康老年人相比，AD 患者的短潜伏期传入抑制 (SAI) 和静息运动阈值显着降低。其他皮质反应性测量的结果，例如皮质内抑制（ICI）的情况更加不同。乙酰胆碱酯酶抑制剂和多巴胺能药物可能会增加 AD 中的 SAI 和 ICI。 AD 中运动皮质的可塑性和连通性受损。 TMS/tDCS 可以对认知功能产生急性和短期的有益影响，但对 AD 的治疗临床意义尚不清楚。迄今为止的研究支持 TMS/tDCS 的安全性。 TMS/tDCS 在 AD 中似乎是安全的，但长期风险尚未得到充分考虑。 TMS 有希望作为 AD 的生理生物标志物来识别治疗靶点并监测药理作用。此外，TMS/tDCS 可能对 AD 具有治疗效用，尽管证据仍非常初步，需要谨慎解释。
A number of studies have applied transcranial magnetic stimulation (TMS) to physiologically characterize Alzheimer’s disease (AD) and to monitor effects of pharmacological agents, while others have begun to therapeutically use TMS and transcranial direct current stimulation (tDCS) to improve cognitive function in AD. These applications are still very early in development, but offer the opportunity of learning from them for future development. We performed a systematic search of all studies using noninvasive stimulation in AD and reviewed all 29 identified articles. Twenty-four focused on measures of motor cortical reactivity and (local) plasticity and functional connectivity, with eight of these studies assessing also effects of pharmacological agents. Five studies focused on the enhancement of cognitive function in AD. Short-latency afferent inhibition (SAI) and resting motor threshold are significantly reduced in AD patients as compared to healthy elders. Results on other measures of cortical reactivity, e.g. intracortical inhibition (ICI), are more divergent. Acetylcholine-esterase inhibitors and dopaminergic drugs may increase SAI and ICI in AD. Motor cortical plasticity and connectivity are impaired in AD. TMS/tDCS can induce acute and short-duration beneficial effects on cognitive function, but the therapeutic clinical significance in AD is unclear. Safety of TMS/tDCS is supported by studies to date. TMS/tDCS appears safe in AD, but longer-term risks have been insufficiently considered. TMS holds promise as a physiologic biomarker in AD to identify therapeutic targets and monitor pharmacologic effects. In addition, TMS/tDCS may have therapeutic utility in AD, though the evidence is still very preliminary and cautious interpretation is warranted.
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影响因子：
2.4
作者：
Bouwens, Sharon F. M.;van Heugten, Caroline M.;Verhey, Frans R. J.
通讯作者：
Verhey, Frans R. J.
影响因子：
1.1
作者：
Chen, Robert;Udupa, Kaviraja
通讯作者：
Udupa, Kaviraja
影响因子：
--
作者：
Cotelli, Maria;Manenti, Rosa;Miniussi, Carlo
通讯作者：
Miniussi, Carlo
影响因子：
4.2
作者：
BARNES, CA
通讯作者：
BARNES, CA
影响因子：
5.5
作者：
Cheeran, Binith;Talelli, Penelope;Rothwell, John C.
通讯作者：
Rothwell, John C.