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深部脑刺激记忆回路:改善阿尔茨海默病认知。

Deep Brain Stimulation of the Memory Circuit: Improving Cognition in Alzheimer's Disease.

机构信息

South London and Maudsley NHS Foundation Trust, London, UK.

Institute of Psychiatry, Psychology and Neuroscience, London, UK.

出版信息

J Alzheimers Dis. 2018;64(2):337-347. doi: 10.3233/JAD-180212.

Abstract

Deep brain stimulation (DBS) is an effective invasive treatment for a wide range of neurological and psychiatric disorders. Neurosurgically implanted electrodes deliver stimulation of pre-programmed amplitude, frequency, and pulse width within deep brain structures; those settings can be adjusted at a later stage according to individual needs for optimal response. This results in variable effects dependent on the targeted region. An established treatment for movement disorders, the effectiveness of DBS in dementia remains under investigation. Translational studies have uncovered a pro-cognitive effect mediated by changes on cellular as well as network level. Several groups have attempted to examine the benefits of DBS in Alzheimer's disease; differences in inclusion criteria and methodology make generalization of results difficult. This review aims to summarize all completed and ongoing human studies of DBS in Alzheimer's disease. The results are classified by targeted anatomical structure. Future directions, as well as economical and ethical arguments, are explored in the final section.

摘要

脑深部电刺激(DBS)是一种广泛应用于治疗多种神经和精神疾病的有效有创治疗方法。通过神经外科手术植入的电极在大脑深部结构中提供预定幅度、频率和脉冲宽度的刺激;这些设置可以根据个体的需求在后期进行调整,以达到最佳的反应效果。这种刺激效果会因目标区域的不同而有所不同。作为一种治疗运动障碍的成熟方法,DBS 在痴呆症中的疗效仍在研究中。转化研究揭示了细胞和网络水平变化介导的认知益处。有几个研究小组试图研究 DBS 在阿尔茨海默病中的益处;由于纳入标准和方法的差异,使得结果难以推广。本篇综述旨在总结所有已完成和正在进行的 DBS 治疗阿尔茨海默病的人类研究。结果根据目标解剖结构进行分类。最后一节探讨了未来的发展方向以及经济和伦理方面的论点。

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