Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, Germany.
European Graduate School of Neuroscience, Maastricht, The Netherlands.
J Alzheimers Dis. 2019;69(4):905-919. doi: 10.3233/JAD-180133.
The nucleus basalis of Meynert (nbM) was first described at the end of the 19th century and named after its discoverer, Theodor Meynert. The nbM contains a large population of cholinergic neurons that project their axons to the entire cortical mantle, the olfactory tubercle, and the amygdala. It has been functionally associated with the control of attention and maintenance of arousal, both key functions for appropriate learning and memory formation. This structure is well-conserved across vertebrates, although its degree of organization varies between species. Since early in the investigation of its functional and pathological significance, its degeneration has been linked to various major neuropsychiatric disorders. For instance, Lewy bodies, a hallmark in the diagnosis of Parkinson's disease, were originally described in the nbM. Since then, its involvement in other Lewy body and dementia-related disorders has been recognized. In the context of recent positive outcomes following nbM deep brain stimulation in subjects with dementia-associated disorders, we review the literature from an historical perspective focusing on how the nbM came into focus as a promising therapeutic option for patients with Alzheimer's disease. Moreover, we will discuss what is needed to further develop and widely implement this approach as well as examine novel medical indications for which nbM deep brain stimulation may prove beneficial.
基底核 Meynert 核（nbM）最初于 19 世纪末被描述，并以其发现者 Theodor Meynert 的名字命名。nbM 包含大量胆碱能神经元，其轴突投射到整个大脑皮质、嗅结节和杏仁核。它与注意力的控制和觉醒的维持有关，这两个功能对于适当的学习和记忆形成都是关键的。该结构在脊椎动物中很好地保守，但在物种之间其组织程度有所不同。自从对其功能和病理意义的早期研究以来，其退化已与各种主要的神经精神疾病有关。例如，路易体，帕金森病诊断的标志，最初在 nbM 中被描述。从那时起，人们已经认识到它与其他路易体和痴呆相关疾病有关。在与痴呆相关疾病的患者接受 nbM 深部脑刺激后取得积极结果的背景下，我们从历史角度回顾了文献，重点介绍了 nbM 如何成为治疗阿尔茨海默病患者的有前途的治疗选择。此外，我们将讨论需要进一步开发和广泛实施这一方法的问题，并研究可能对 nbM 深部脑刺激有益的新的医学适应症。
