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刺激还是退变:阿尔茨海默病中基底核 Meynert 核的深部脑刺激。

Stimulate or degenerate: deep brain stimulation of the nucleus basalis Meynert in Alzheimer dementia.

机构信息

Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.

出版信息

World Neurosurg. 2013 Sep-Oct;80(3-4):S27.e35-43. doi: 10.1016/j.wneu.2012.12.005. Epub 2012 Dec 12.

Abstract

OBJECTIVE

Deep brain stimulation (DBS) is a therapeutically effective neurosurgical method originally applied in movement disorders. Over time, the application of DBS has increasingly been considered as a therapeutic option for several neuropsychiatric disorders, including Gilles de la Tourette syndrome, obsessive compulsive disorder, major depression and addiction. Latest research suggests beneficial effects of DBS in Alzheimer dementia (AD). Because of the high prevalence and the considerable burden of the disease, we endeavored to discuss and reveal the challenges of DBS in AD.

METHODS

Recent literature on the pathophysiology of AD, including translational data and human studies, has been studied to generate a fundamental hypothesis regarding the effects of electrical stimulation on cognition and to facilitate our ongoing pilot study regarding DBS of the nucleus basalis Meynert (NBM) in patients with AD.

RESULTS

It is hypothesized that DBS in the nucleus basalis Meynert could probably improve or at least stabilize memory and cognitive functioning in patients with AD by facilitating neural oscillations and by enhancing the synthesis of nerve growth factors.

CONCLUSIONS

Considering the large number of patients suffering from AD, there is a great need for novel and effective treatment methods. Our research provides insights into the theoretical background of DBS in AD. Providing that our hypothesis will be validated by our ongoing pilot study, DBS could be an opportunity in the treatment of AD.

摘要

目的

深部脑刺激(DBS)是一种治疗有效的神经外科方法,最初应用于运动障碍。随着时间的推移,DBS 的应用越来越被认为是几种神经精神疾病的治疗选择,包括 Gilles de la Tourette 综合征、强迫症、重度抑郁症和成瘾。最新研究表明 DBS 对阿尔茨海默病(AD)有益。由于该疾病的高患病率和相当大的负担,我们努力讨论和揭示 DBS 在 AD 中的挑战。

方法

研究了 AD 的发病机制的最新文献,包括转化数据和人类研究,以产生关于电刺激对认知影响的基本假设,并为我们正在进行的 AD 患者基底核 Meynert 核(NBM)DBS 试点研究提供便利。

结果

据推测,通过促进神经振荡和增强神经生长因子的合成,NBM 的 DBS 可能会改善或至少稳定 AD 患者的记忆和认知功能。

结论

鉴于有大量的 AD 患者,迫切需要新的有效治疗方法。我们的研究为 AD 中 DBS 的理论背景提供了深入了解。如果我们的假设将通过我们正在进行的试点研究得到验证,那么 DBS 可能是 AD 治疗的一个机会。

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