van den Bos Mehdi A J, Menon Parvathi, Vucic Steve
Brain and Nerve Research Centre, Concord Repatriation General Hospital, Sydney, Australia.
Expert Rev Neurother. 2022 Nov-Dec;22(11-12):981-993. doi: 10.1080/14737175.2022.2170784.
Transcranial magnetic stimulation (TMS) is a non-invasive neurophysiological tool that provides important insights into Alzheimer's Disease (AD). A significant body of work utilizing TMS techniques has explored the pathophysiological relevance of cortical hyperexcitability and plasticity in AD and their modulation in novel therapies.
This review examines the technique of TMS, the use of TMS to examine specific features of cortical excitability and the use of TMS techniques to modulate cortical function. A search was performed utilizing the PubMed database to identify key studies utilizing TMS to examine cortical hyperexcitability and plasticity in Alzheimer's dementia. We then translate this understanding to the study of Alzheimer's disease pathophysiology, examining the underlying neurophysiologic links contributing to these twin signatures, cortical hyperexcitability and abnormal plasticity, in the cortical dysfunction characterizing AD. Finally, we examine utilization of TMS excitability to guide targeted therapies and, through the use of repetitive TMS (rTMS), modulate cortical plasticity.
The examination of cortical hyperexcitability and plasticity with TMS has potential to optimize and expand the window of therapeutic interventions in AD, though remains at relatively early stage of development.
经颅磁刺激（TMS）是一种非侵入性神经生理学工具，能为阿尔茨海默病（AD）提供重要见解。大量利用TMS技术的研究探讨了AD中皮质兴奋性过高和可塑性的病理生理相关性及其在新疗法中的调节作用。
本综述考察了TMS技术、利用TMS检查皮质兴奋性的特定特征以及利用TMS技术调节皮质功能。利用PubMed数据库进行检索，以确定利用TMS检查阿尔茨海默病痴呆中皮质兴奋性过高和可塑性的关键研究。然后，我们将这种认识应用于阿尔茨海默病病理生理学研究，考察在AD特征性皮质功能障碍中导致皮质兴奋性过高和异常可塑性这两个特征的潜在神经生理联系。最后，我们考察利用TMS兴奋性来指导靶向治疗，并通过重复经颅磁刺激（rTMS）调节皮质可塑性。
用TMS检查皮质兴奋性过高和可塑性有可能优化和扩大AD治疗干预的窗口，不过仍处于相对早期的发展阶段。
