Institute of Emergency Rescue Medicine, Emergency Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China.
Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China.
Neurochem Int. 2022 Jul;157:105356. doi: 10.1016/j.neuint.2022.105356. Epub 2022 May 2.
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique. Recently, rTMS has shown promising therapeutic potential in multiple neurological conditions. Nevertheless, challenges remain in the clinical application of rTMS, which mainly due to the lack of consensus on optimal stimulation protocols and poor understanding of the exact targets driving its action. Experimental animal research with more controllable factors may contribute to fill our knowledge gap in this area, and to accelerate the development of clinical translation studies. Therefore, the current study was designed to systematically review the effects of rTMS on animal models of certain diseases and evaluate its potential mechanisms of action, which may guide future studies aiming to improve the therapeutic utilization for these diseases.
A systematic literature search was conducted through the PubMed online database on August 19, 2021. The search strategy consisted of two main components: rTMS and stroke, Alzheimer's disease (AD), vascular dementia (VaD), and Parkinson's disease (PD), with results limited to animal studies.
We identified 41 animal studies, 21 that examined stroke, 8 that investigated Alzheimer's disease, 5 that studied vascular dementia, and 7 that examined Parkinson's disease, all of these studies were conducted in rodents (rat and mice). Despite variations in study design and research methods, the therapeutic benefits of rTMS, as reflected in the alleviation of disease-related symptoms and pathological improvements, have been reported in these studies. rTMS induces multi-directional changes at the cellular and molecular levels, including a significant contribution to synaptic plasticity. Furthermore, the curative effects of rTMS are related to stimulation parameters, with high-frequency rTMS reported has better therapeutic efficacy in several studies. In terms of safety, one study involving combination therapy reported the adverse effects of rTMS administration.
rTMS have shown encouraging therapeutic value in rodent models of stroke, AD, VaD, and PD. Nonetheless, the optimal protocols and exact target of action for this therapy remain to be determined. Correspondingly, further research is still needed to bridge the translation gap between rodent experiments and clinical application, which might lead to new directions in the treatment of multiple neurological disorders.
重复经颅磁刺激（rTMS）是一种非侵入性的神经调节技术。最近，rTMS 在多种神经疾病的治疗中显示出有前景的治疗潜力。然而，rTMS 的临床应用仍面临挑战，主要是因为缺乏关于最佳刺激方案的共识，以及对其作用的确切靶点理解不足。具有更多可控因素的实验动物研究可能有助于填补这一领域的知识空白，并加速临床转化研究的发展。因此，本研究旨在系统地综述 rTMS 对某些疾病动物模型的影响，并评估其潜在的作用机制，这可能为旨在改善这些疾病治疗效果的未来研究提供指导。
通过 2021 年 8 月 19 日的 PubMed 在线数据库进行了系统的文献检索。搜索策略由两部分组成：rTMS 和中风、阿尔茨海默病（AD）、血管性痴呆（VaD）和帕金森病（PD），结果仅限于动物研究。
我们共确定了 41 项动物研究，其中 21 项研究中风，8 项研究阿尔茨海默病，5 项研究血管性痴呆，7 项研究帕金森病，这些研究均在啮齿动物（大鼠和小鼠）中进行。尽管研究设计和研究方法存在差异，但 rTMS 的治疗益处，即减轻与疾病相关的症状和改善病理，在这些研究中均有报道。rTMS 在细胞和分子水平上引起多方向的变化，对突触可塑性有重要贡献。此外，rTMS 的疗效与刺激参数有关，几项研究报告高频 rTMS 具有更好的治疗效果。在安全性方面，一项涉及联合治疗的研究报告了 rTMS 给药的不良反应。
rTMS 在中风、AD、VaD 和 PD 的啮齿动物模型中显示出令人鼓舞的治疗价值。然而，这种治疗的最佳方案和确切作用靶点仍有待确定。相应地，仍需要进一步的研究来弥合啮齿动物实验和临床应用之间的转化差距，这可能为多种神经疾病的治疗开辟新的方向。
