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重复经颅磁刺激治疗隐球菌性脑膜炎合并认知障碍的病例研究

A case study of repetitive transcranial magnetic stimulation for cryptococcal meningitis combined with cognitive impairment.

作者信息

Liu Yuanbiao, Fan Lei, Jiang Xinlin, Lu Yi, Li Yige

机构信息

Department of Rehabilitation Medicine, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Physical Medicine and Rehabilitation Unit, Nanjing Medical University, Nanjing, China.

出版信息

Front Hum Neurosci. 2022 Dec 16;16:1061916. doi: 10.3389/fnhum.2022.1061916. eCollection 2022.

Abstract

Cryptococcal meningitis (CM) is a central nervous system disease caused by a novel infection that leads to subacute or chronic inflammatory changes in the nervous system. In this study, we present the case of a woman aged 72 years with CM and severe cognitive impairment and disabilities. The cognitive assessment indicated that, although her cognitive function was impaired, especially executive function, it largely improved after receiving anti-infectious and repetitive transcranial magnetic stimulation, which can alter the membrane potential of the cortical nerve cells by triggering long-term potentiation and depression, modulating and releasing hormones, reducing the level of neuroinflammatory and peripheral blood cytokines, promoting nerve regeneration and synaptic remodeling, and changing the activity of the neural circuitry of the dorsolateral prefrontal cortex. We argue that this case provides a novel method of treatment for patients with CM in conjunction with cognitive impairments.

摘要

隐球菌性脑膜炎(CM)是一种由新型感染引起的中枢神经系统疾病,可导致神经系统发生亚急性或慢性炎症变化。在本研究中,我们报告了一例72岁患有CM且伴有严重认知障碍和残疾的女性病例。认知评估表明,尽管她的认知功能受损,尤其是执行功能,但在接受抗感染治疗和重复经颅磁刺激后有很大改善,重复经颅磁刺激可通过触发长时程增强和抑制、调节和释放激素、降低神经炎症和外周血细胞因子水平、促进神经再生和突触重塑以及改变背外侧前额叶皮质神经回路的活动来改变皮质神经细胞的膜电位。我们认为该病例为伴有认知障碍的CM患者提供了一种新的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340a/9800931/f115cb22786d/fnhum-16-1061916-g0001.jpg

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