Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, ON, Canada.
Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
J Alzheimers Dis. 2020;78(4):1299-1313. doi: 10.3233/JAD-200913.
Neuromodulation as a treatment strategy for psychiatric and neurological diseases has grown in popularity in recent years, with the approval of repetitive transcranial magnetic stimulation (rTMS) for the treatment of depression being one such example. These approaches offer new hope in the treatment of diseases that have proven largely intractable to traditional pharmacological approaches. For this reason, neuromodulation is increasingly being explored for the treatment of Alzheimer's disease. However, such approaches have variable, and, in many cases, very limited evidence for safety and efficacy, with most human evidence obtained in small clinical trials. Here we review work in animal models and humans with Alzheimer's disease exploring emerging neuromodulation modalities. Approaches reviewed include deep brain stimulation, transcranial magnetic stimulation, transcranial electrical stimulation, ultrasound stimulation, photobiomodulation, and visual or auditory stimulation. In doing so, we clarify the current evidence for these approaches in treating Alzheimer's disease and identify specific areas where additional work is needed to facilitate their clinical translation.
近年来,神经调节作为一种治疗精神和神经疾病的策略越来越受到欢迎,其中一个例子是重复经颅磁刺激(rTMS)被批准用于治疗抑郁症。这些方法为治疗那些经传统药物治疗方法证明难以治疗的疾病带来了新的希望。出于这个原因,神经调节越来越多地被用于治疗阿尔茨海默病。然而,这些方法的安全性和有效性证据各不相同,在许多情况下非常有限,大多数人类证据都是从小型临床试验中获得的。在这里,我们回顾了在患有阿尔茨海默病的动物模型和人类中探索新兴神经调节方式的研究工作。所审查的方法包括深部脑刺激、经颅磁刺激、经颅电刺激、超声刺激、光生物调节以及视觉或听觉刺激。这样做的同时,我们澄清了这些方法在治疗阿尔茨海默病方面的现有证据,并确定了需要进一步研究的特定领域,以促进其临床转化。