阿尔茨海默病患者经颅磁刺激（TPS）脑刺激效应的功能特异性：一项随访功能磁共振成像分析
Functional Specificity of TPS Brain Stimulation Effects in Patients with Alzheimer's Disease: A Follow-up fMRI Analysis.
作者信息
Dörl Gregor, Matt Eva, Beisteiner Roland
机构信息
Department of Neurology, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
出版信息
Neurol Ther. 2022 Sep;11(3):1391-1398. doi: 10.1007/s40120-022-00362-8. Epub 2022 May 28.
INTRODUCTION
Transcranial pulse stimulation (TPS) has been recently introduced as a novel clinical brain stimulation technique based on highly focused ultrasound pressure pulses. In a first pilot study on clinical effects of navigated and focused ultrasound neuromodulation, a dichotomy of functional effects was found: patients with Alzheimer's disease improved cognition and language but deteriorated with visuo-constructive functions.
METHODS
We analyzed changes in functional connectivity measured with functional magnetic resonance imaging (fMRI) using graph analysis of a visuo-constructive network in 18 patients with Alzheimer's disease. We calculated the network's global efficiency and tested for correlation with visuo-constructive test scores to explain this dichotomy.
RESULTS
Important visuo-constructive network nodes were not stimulated in the pilot setting and correspondingly global efficiency of a visuo-constructive network was decreased after TPS therapy, compatible with a natural progress of the disease. A correlation between visuo-constructive scores and changes in global efficiency was found.
CONCLUSION
Results argue for a high functional specificity of ultrasound-based neuromodulation with TPS.
引言
经颅脉冲刺激（TPS）最近作为一种基于高度聚焦超声压力脉冲的新型临床脑刺激技术被引入。在一项关于导航和聚焦超声神经调节临床效果的初步试验研究中，发现了功能效应的二分法：阿尔茨海默病患者的认知和语言能力得到改善，但视觉构建功能却恶化。
方法
我们使用功能磁共振成像（fMRI）对18例阿尔茨海默病患者的视觉构建网络进行图形分析，以分析功能连接性的变化。我们计算了该网络的全局效率，并测试其与视觉构建测试分数的相关性，以解释这种二分法。
结果
在初步试验设置中，重要的视觉构建网络节点未受到刺激，相应地，TPS治疗后视觉构建网络的全局效率降低，这与疾病的自然进展相符。发现视觉构建分数与全局效率变化之间存在相关性。
结论
结果表明基于超声的神经调节与TPS具有高度的功能特异性。
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