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神经刺激治疗癫痫患者的记忆增强。

Neurostimulation for Memory Enhancement in Epilepsy.

机构信息

Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.

Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

出版信息

Curr Neurol Neurosci Rep. 2018 Apr 19;18(6):30. doi: 10.1007/s11910-018-0837-3.

Abstract

PURPOSE OF REVIEW

Memory is one of the top concerns of epilepsy patients, but there are no known treatments to directly alleviate the memory deficits associated with epilepsy. Neurostimulation may provide new therapeutic tools to enhance memory in epilepsy patients. Here, we critically review recent investigations of memory enhancement using transcranial electrical stimulation (tES), transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), chronic intracranial stimulation, and acute intracranial stimulation.

RECENT FINDINGS

Existing literature suggests that transcranial direct current stimulation (tDCS) produces a small enhancement in memory in neuropsychological patients, but transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS) have not been found to have an effect on memory. Most studies of transcranial magnetic stimulation (TMS) have found that TMS has no positive effect on memory. Vagus nerve stimulation can acutely enhance memory, while chronic therapy does not appear to alter memory performance. We found that there is the most evidence for significant memory enhancement using intracranial stimulation techniques, especially chronic stimulation of the fornix and task-responsive stimulation of the lateral temporal lobe. Presently, there are no existing therapeutic options for directly treating epilepy-related memory deficits. While neurostimulation technologies for memory enhancement are largely still in the experimental phase, neurostimulation appears promising as a future technique for treating epilepsy-related memory deficits.

摘要

目的综述

记忆是癫痫患者最关心的问题之一,但目前尚无已知的治疗方法可以直接缓解与癫痫相关的记忆缺陷。神经刺激可能为增强癫痫患者的记忆提供新的治疗工具。在这里,我们批判性地回顾了最近使用经颅电刺激(tES)、经颅磁刺激(TMS)、迷走神经刺激(VNS)、慢性颅内刺激和急性颅内刺激来增强记忆的研究。

最新发现

现有文献表明,经颅直流电刺激(tDCS)可使神经心理患者的记忆得到轻微增强,但经颅交流电刺激(tACS)和经颅随机噪声刺激(tRNS)对记忆没有影响。大多数 TMS 研究发现 TMS 对记忆没有积极影响。迷走神经刺激可以急性增强记忆,而慢性治疗似乎不会改变记忆表现。我们发现,使用颅内刺激技术可以显著增强记忆,尤其是对穹窿的慢性刺激和对侧颞叶的任务响应性刺激。目前,尚无直接治疗癫痫相关记忆缺陷的治疗方法。虽然用于增强记忆的神经刺激技术在很大程度上仍处于实验阶段,但神经刺激作为治疗癫痫相关记忆缺陷的未来技术具有广阔的前景。

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