Terranova Carmen, Rizzo Vincenzo, Cacciola Alberto, Chillemi Gaetana, Calamuneri Alessandro, Milardi Demetrio, Quartarone Angelo
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
Front Neurol. 2019 Jan 24;9:1146. doi: 10.3389/fneur.2018.01146. eCollection 2018.
Several techniques and protocols of non-invasive transcranial brain stimulation (NIBS), including transcranial magnetic and electrical stimuli, have been developed in the past decades. These techniques can induce long lasting changes in cortical excitability by promoting synaptic plasticity and thus may represent a therapeutic option in neuropsychiatric disorders. On the other hand, despite these techniques have become popular, the fragility and variability of the after effects are the major challenges that non-invasive transcranial brain stimulation currentlyfaces. Several factors may account for such a variability such as biological variations, measurement reproducibility, and the neuronal state of the stimulated area. One possible strategy, to reduce this variability is to monitor the neuronal state in real time using EEG and trigger TMS pulses only at pre-defined state. In addition, another strategy under study is to use the spaced application of multiple NIBS protocols within a session to improve the reliability and extend the duration of NIBS effects. Further studies, although time consuming, are required for improving the so far limited effect sizes of NIBS protocols for treatment of neurological or psychiatric disorders.
在过去几十年里，已经开发出了多种无创经颅脑刺激（NIBS）技术和方案，包括经颅磁刺激和电刺激。这些技术可以通过促进突触可塑性来诱导皮质兴奋性的长期变化，因此可能成为神经精神疾病的一种治疗选择。另一方面，尽管这些技术已经很流行，但后效应的脆弱性和变异性是无创经颅脑刺激目前面临的主要挑战。生物变异、测量可重复性以及受刺激区域的神经元状态等几个因素可能导致这种变异性。一种可能的策略是使用脑电图实时监测神经元状态，并仅在预定义状态下触发经颅磁刺激脉冲，以减少这种变异性。此外，正在研究的另一种策略是在一次治疗中采用多个NIBS方案的间隔应用，以提高可靠性并延长NIBS效应的持续时间。尽管耗时，但仍需要进一步研究来改善目前NIBS方案在治疗神经或精神疾病方面有限的效应大小。
