Fernandez Fabian, Garner Craig C
Department of Psychiatry and Behavioral Sciences, Nancy Pritzker Laboratory, Stanford University, 1201 Welch Rd, Palo Alto, CA 94304-5485, USA.
Trends Neurosci. 2007 Oct;30(10):497-503. doi: 10.1016/j.tins.2007.07.005. Epub 2007 Sep 6.
Developmental intellectual disability (DID) is a daunting societal problem. Although tremendous progress has been made in defining the genetic causes of DID, therapeutic strategies remain limited. In particular, there is a marked absence of a unified approach to treating cognitive impairments associated with DID. Here, we suggest that the brain in many DID-related disorders is subject to a basic imbalance in neuronal activity, with an increased contribution of inhibition to neural circuits. This over-inhibition, in turn, is predicted to lead to deficits in synaptic plasticity and learning and memory. We further discuss possibilities for pharmacological intervention in DID, focusing on the concept of drug-induced 'therapeutic neuroadaptation' as a means of stably enhancing constitutive circuit excitability and cognition over time.
发育性智力障碍(DID)是一个令人望而生畏的社会问题。尽管在确定DID的遗传病因方面已经取得了巨大进展,但治疗策略仍然有限。特别是,在治疗与DID相关的认知障碍方面,明显缺乏统一的方法。在这里,我们认为,在许多与DID相关的疾病中,大脑存在神经元活动的基本失衡,抑制对神经回路的贡献增加。反过来,这种过度抑制预计会导致突触可塑性以及学习和记忆方面的缺陷。我们进一步讨论了DID药物干预的可能性,重点关注药物诱导的“治疗性神经适应”概念,作为随着时间的推移稳定增强组成性回路兴奋性和认知的一种手段。