Department of Cell Biology, University of South Florida, Tampa, FL, USA.
J Alzheimers Dis. 2012;32(2):243-66. doi: 10.3233/JAD-2012-120943.
The universal failure of pharmacologic interventions against Alzheimer's disease (AD) appears largely due to their inability to get into neurons and the fact that most have a single mechanism-of-action. A non-invasive, neuromodulatory approach against AD has consequently emerged: transcranial electromagnetic treatment (TEMT). In AD transgenic mice, long-term TEMT prevents and reverses both cognitive impairment and brain amyloid-β (Aβ) deposition, while TEMT even improves cognitive performance in normal mice. Three disease-modifying and inter-related mechanisms of TEMT action have been identified in the brain: 1) anti-Aβ aggregation, both intraneuronally and extracellularly; 2) mitochondrial enhancement; and 3) increased neuronal activity. Long-term TEMT appears safe in that it does not impact brain temperature or oxidative stress levels, nor does it induce any abnormal histologic/anatomic changes in the brain or peripheral tissues. Future TEMT development in both AD mice and normal mice should involve head-only treatment to discover the most efficacious set of parameters for achieving faster and even greater cognitive benefit. Given the already extensive animal work completed, translational development of TEMT could occur relatively quickly to "proof of concept" AD clinical trials. TEMT's mechanisms of action provide extraordinary therapeutic potential against other neurologic disorders/injuries, such as Parkinson's disease, traumatic brain injury, and stroke.
针对阿尔茨海默病(AD)的药物干预普遍失败,主要原因似乎是这些药物无法进入神经元,而且大多数药物只有单一的作用机制。因此,出现了一种非侵入性的神经调节治疗方法:经颅电磁治疗(TEMT)。在 AD 转基因小鼠中,长期 TEMT 可预防和逆转认知障碍和脑淀粉样蛋白-β(Aβ)沉积,甚至可改善正常小鼠的认知表现。在大脑中已经确定了 TEMT 作用的三种具有疾病修饰和相互关联的机制:1)抗 Aβ聚集,包括神经元内和细胞外;2)线粒体增强;3)增加神经元活性。长期 TEMT 似乎是安全的,因为它不会影响大脑温度或氧化应激水平,也不会在大脑或外周组织中引起任何异常的组织学/解剖学变化。未来在 AD 小鼠和正常小鼠中进行的 TEMT 开发应仅涉及头部治疗,以发现实现更快、更显著认知益处的最有效参数集。鉴于已经完成了广泛的动物研究,TEMT 的转化开发可能相对较快地进入“概念验证”AD 临床试验。TEMT 的作用机制为治疗其他神经疾病/损伤(如帕金森病、创伤性脑损伤和中风)提供了非凡的治疗潜力。