Brain Investigation and Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy.
Unit of Neuroimaging and Neurointervention, "Santa Maria alle Scotte" Medical Center, Siena, Italy.
Sci Adv. 2019 Aug 14;5(8):eaau9309. doi: 10.1126/sciadv.aau9309. eCollection 2019 Aug.
Malignant brain neoplasms have a poor prognosis despite aggressive treatments. Animal models and evidence from human bodily tumors reveal that sustained reduction in tumor perfusion via electrical stimulation promotes tumor necrosis, therefore possibly representing a therapeutic option for patients with brain tumors. Here, we demonstrate that transcranial electrical stimulation (tES) allows to safely and noninvasively reduce intratumoral perfusion in humans. Selected patients with glioblastoma or metastasis underwent tES, while perfusion was assessed using magnetic resonance imaging. Multichannel tES was applied according to personalized biophysical modeling, to maximize the induced electrical field over the solid tumor mass. All patients completed the study and tolerated the procedure without adverse effects, with tES selectively reducing the perfusion of the solid tumor. Results potentially open the door to noninvasive therapeutic interventions in brain tumors based on stand-alone tES or its combination with other available therapies.
尽管采用了积极的治疗方法，恶性脑肿瘤的预后仍然很差。动物模型和人体肿瘤的证据表明，通过电刺激持续减少肿瘤灌注可促进肿瘤坏死，因此可能代表了脑肿瘤患者的一种治疗选择。在这里，我们证明经颅电刺激 (tES) 可安全、非侵入性地降低人体肿瘤内的灌注。选择患有胶质母细胞瘤或转移瘤的患者进行 tES，同时使用磁共振成像评估灌注。根据个性化的生物物理模型应用多通道 tES，以最大限度地提高实体瘤上的诱导电场。所有患者均完成了研究且无不良反应，tES 选择性地降低了实体瘤的灌注。这些结果可能为基于单独 tES 或其与其他可用疗法相结合的脑肿瘤的无创治疗干预措施打开大门。
