National Institute of Mental Health Intramural Research Program, National Institutes of Health, Bethesda, Maryland.
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Biol Psychiatry. 2024 Mar 15;95(6):581-591. doi: 10.1016/j.biopsych.2023.07.012. Epub 2023 Jul 29.
Transcranial magnetic stimulation (TMS) has emerged as a pivotal noninvasive technique for investigating cortical excitability and plasticity across the lifespan, offering valuable insights into neurodevelopmental and neurodegenerative processes. In this review, we explore the impact of TMS applications on our understanding of normal development, healthy aging, neurodevelopmental disorders, and adult-onset neurodegenerative diseases. By presenting key developmental milestones and age-related changes in TMS measures, we provide a foundation for understanding the maturation of neurotransmitter systems and the trajectory of cognitive functions throughout the lifespan. Building on this foundation, the paper delves into the pathophysiology of neurodevelopmental disorders, including autism spectrum disorder, attention-deficit/hyperactivity disorder, Tourette syndrome, and adolescent depression. Highlighting recent findings on altered neurotransmitter circuits and dysfunctional cortical plasticity, we underscore the potential of TMS as a valuable tool for unraveling underlying mechanisms and informing future therapeutic interventions. We also review the emerging role of TMS in investigating and treating the most common adult-onset neurodegenerative disorders and late-onset depression. By outlining the therapeutic applications of noninvasive brain stimulation techniques in these disorders, we discuss the growing body of evidence supporting their use as therapeutic tools for symptom management and potentially slowing disease progression. The insights gained from TMS studies have advanced our understanding of the underlying mechanisms in both healthy and disease states, ultimately informing the development of more targeted diagnostic and therapeutic strategies for a wide range of neuropsychiatric conditions.
经颅磁刺激(TMS)已成为一种重要的非侵入性技术,可用于研究整个生命周期中的皮质兴奋性和可塑性,为神经发育和神经退行性过程提供了有价值的见解。在这篇综述中,我们探讨了 TMS 应用对我们理解正常发育、健康衰老、神经发育障碍和成人发病的神经退行性疾病的影响。通过介绍 TMS 测量中的关键发育里程碑和与年龄相关的变化,我们为理解神经递质系统的成熟和认知功能在整个生命周期中的轨迹提供了基础。在此基础上,本文深入探讨了神经发育障碍的病理生理学,包括自闭症谱系障碍、注意力缺陷/多动障碍、妥瑞氏症和青少年抑郁症。强调了改变的神经递质回路和皮质可塑性功能障碍的最新发现,强调了 TMS 作为揭示潜在机制和为未来治疗干预提供信息的有价值工具的潜力。我们还回顾了 TMS 在研究和治疗最常见的成人发病的神经退行性疾病和迟发性抑郁症中的新兴作用。通过概述这些疾病中非侵入性脑刺激技术的治疗应用,我们讨论了越来越多的证据支持将其用作症状管理和潜在减缓疾病进展的治疗工具。TMS 研究的见解推进了我们对健康和疾病状态下潜在机制的理解,最终为广泛的神经精神疾病制定更有针对性的诊断和治疗策略提供了信息。