Rubio-Morell Belén, Rotenberg Alexander, Hernández-Expósito Sergio, Pascual-Leone Álvaro
Unidad de Psiquiatria Infanto-Juvenil, Hospital Universitario de Canarias, Ofra, s/n. E-33200 La Laguna (Tenerife), España.
Rev Neurol. 2011 Aug 16;53(4):209-25.
Novel diagnostic and therapeutic approaches based on noninvasive brain stimulation offer some promise in the field of childhood psychiatric disorders. There are two primary methods of noninvasive brain stimulation currently available: transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). Both noninvasive neuromodulation techniques appear to rely on modulating brain plasticity and thus open new hopes in the treatment of brain circuit and plasticity disorders. Since many childhood psychiatric disorders involve disturbances in the timing or mechanisms of plasticity within frontostriatal circuits, and the developing brain shows a greater capacity of brain plasticity, noninvasive brain stimulation might induce greater benefits in this population than in adults. Although the utilization of TMS and tDCS remains limited in children, there is enough evidence for their rational, safe use in this population. In this paper, we review the principles of noninvasive brain stimulation and the diagnostic and therapeutic applications in child-hood psychiatric disorders in order to inform its development into safe and reliable diagnostic and effective therapeutic approaches in pediatric psychiatry.
基于无创脑刺激的新型诊断和治疗方法在儿童精神疾病领域展现出了一定的前景。目前有两种主要的无创脑刺激方法：经颅磁刺激（TMS）和经颅直流电刺激（tDCS）。这两种无创神经调节技术似乎都依赖于调节脑可塑性，从而为治疗脑回路和可塑性障碍带来了新的希望。由于许多儿童精神疾病涉及额纹状体回路中可塑性的时间或机制紊乱，且发育中的大脑表现出更大的脑可塑性，无创脑刺激在这一人群中可能比在成人中带来更大的益处。尽管TMS和tDCS在儿童中的应用仍然有限，但有足够的证据证明它们在这一人群中合理、安全地使用。在本文中，我们回顾了无创脑刺激的原理以及在儿童精神疾病中的诊断和治疗应用，以便为其发展成为儿科精神病学中安全可靠的诊断和有效治疗方法提供参考。
