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关于如何以及为何使用非侵入性神经刺激技术来探索和调节大脑可塑性,你想了解(但可能不敢问)的事情。

Things you wanted to know (but might have been afraid to ask) about how and why to explore and modulate brain plasticity with non-invasive neurostimulation technologies.

作者信息

Stengel C, Sanches C, Toba M N, Valero-Cabré A

机构信息

Causal Dynamics, Plasticity and Rehabilitation Group, FRONTLAB team, office 3.028, Paris Brain Institute (Institut du Cerveau), CNRS UMR 7225, Inserm UMRS 1127 and Sorbonne Université, 47, boulevard de l'Hôpital, 75013 Paris, France.

Laboratory of Functional Neurosciences (UR UPJV 4559), University Hospital of Amiens and University of Picardie Jules Verne, Amiens, France.

出版信息

Rev Neurol (Paris). 2022 Oct;178(8):826-844. doi: 10.1016/j.neurol.2021.12.014. Epub 2022 May 24.

Abstract

Brain plasticity can be defined as the ability of local and extended neural systems to organize either the structure and/or the function of their connectivity patterns to better adapt to changes of our inner/outer environment and optimally respond to new challenging behavioral demands. Plasticity has been traditionally conceived as a spontaneous phenomenon naturally occurring during pre and postnatal development, tied to learning and memory processes, or enabled following neural damage and their rehabilitation. Such effects can be easily observed and measured but remain hard to harness or to tame 'at will'. Non-invasive brain stimulation (NIBS) technologies offer the possibility to engage plastic phenomena, and use this ability to characterize the relationship between brain regions, networks and their functional connectivity patterns with cognitive process or disease symptoms, to estimate cortical malleability, and ultimately contribute to neuropsychiatric therapy and rehabilitation. NIBS technologies are unique tools in the field of fundamental and clinical research in humans. Nonetheless, their abilities (and also limitations) remain rather unknown and in the hands of a small community of experts, compared to widely established methods such as functional neuroimaging (fMRI) or electrophysiology (EEG, MEG). In the current review, we first introduce the features, mechanisms of action and operational principles of the two most widely used NIBS methods, Transcranial Magnetic Stimulation (TMS) and Transcranial Current Stimulation (tCS), for exploratory or therapeutic purposes, emphasizing their bearings on neural plasticity mechanisms. In a second step, we walk the reader through two examples of recent domains explored by our team to further emphasize the potential and limitations of NIBS to either explore or improve brain function in healthy individuals and neuropsychiatric populations. A final outlook will identify a series of future topics of interest that can foster progress in the field and achieve more effective manipulation of brain plasticity and interventions to explore and improve cognition and treat the symptoms of neuropsychiatric diseases.

摘要

脑可塑性可定义为局部和扩展神经系统组织其连接模式的结构和/或功能,以更好地适应我们内部/外部环境的变化,并对新的具有挑战性的行为需求做出最佳反应的能力。传统上,可塑性被认为是一种在产前和产后发育过程中自然发生的自发现象,与学习和记忆过程相关,或者在神经损伤及其康复后得以实现。这种效应很容易观察和测量,但仍然难以随意利用或控制。非侵入性脑刺激(NIBS)技术提供了引发可塑性现象的可能性,并利用这种能力来表征脑区、网络及其功能连接模式与认知过程或疾病症状之间的关系,估计皮质可塑性,并最终为神经精神治疗和康复做出贡献。NIBS技术是人类基础和临床研究领域的独特工具。然而,与功能神经成像(fMRI)或电生理学(EEG、MEG)等广泛应用的方法相比,它们的能力(以及局限性)仍然鲜为人知,且掌握在一小群专家手中。在本综述中,我们首先介绍两种最广泛使用的NIBS方法——经颅磁刺激(TMS)和经颅电流刺激(tCS)的特点、作用机制和操作原理,用于探索性或治疗性目的,强调它们与神经可塑性机制的关联。第二步,我们带领读者了解我们团队最近探索的两个领域的例子,以进一步强调NIBS在探索或改善健康个体和神经精神疾病人群的脑功能方面的潜力和局限性。最后的展望将确定一系列未来感兴趣的主题,这些主题可以推动该领域的进展,并实现对脑可塑性更有效的操纵以及探索和改善认知并治疗神经精神疾病症状的干预措施。

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