Department of Pharmacology and Biomedical Sciences, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea.
Remed Co. Ltd., 21-7, Weeleseoilo 1, Seongnam, Korea.
Mol Neurobiol. 2024 Mar;61(3):1687-1703. doi: 10.1007/s12035-023-03573-8. Epub 2023 Sep 27.
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation under investigation for treatment of a wide range of neurological disorders. In particular, the therapeutic application of rTMS for neurodegenerative diseases such as Alzheimer's disease (AD) is attracting attention. However, the mechanisms underlying the therapeutic efficacy of rTMS have not yet been elucidated, and few studies have systematically analyzed the stimulation parameters. In this study, we found that treatment with rTMS contributed to restoration of memory deficits by activating genes involved in synaptic plasticity and long-term memory. We evaluated changes in several intracellular signaling pathways in response to rTMS stimulation; rTMS treatment activated STAT, MAPK, Akt/p70S6K, and CREB signaling. We also systematically investigated the influence of rTMS parameters. We found an effective range of applications for rTMS and determined the optimal combination to achieve the highest efficiency. Moreover, application of rTMS inhibited the increase in cell death induced by hydrogen peroxide. These results suggest that rTMS treatment exerts a neuroprotective effect on cellular damage induced by oxidative stress, which plays an important role in the pathogenesis of neurological disorders. rTMS treatment attenuated streptozotocin (STZ)-mediated cell death and AD-like pathology in neuronal cells. In an animal model of sporadic AD caused by intracerebroventricular STZ injection, rTMS application improved cognitive decline and showed neuroprotective effects on hippocampal histology. Overall, this study will help in the design of stimulation protocols for rTMS application and presents a novel mechanism that may explain the therapeutic effects of rTMS in neurodegenerative diseases, including AD.
重复经颅磁刺激(rTMS)是一种正在研究中的非侵入性脑刺激方法,用于治疗广泛的神经疾病。特别是,rTMS 在治疗阿尔茨海默病(AD)等神经退行性疾病方面的应用引起了关注。然而,rTMS 治疗效果的机制尚未阐明,很少有研究系统地分析刺激参数。在这项研究中,我们发现 rTMS 通过激活涉及突触可塑性和长时记忆的基因,有助于恢复记忆缺陷。我们评估了 rTMS 刺激后几种细胞内信号通路的变化;rTMS 治疗激活了 STAT、MAPK、Akt/p70S6K 和 CREB 信号通路。我们还系统地研究了 rTMS 参数的影响。我们发现 rTMS 的有效应用范围,并确定了最佳组合以达到最高效率。此外,rTMS 的应用抑制了过氧化氢诱导的细胞死亡增加。这些结果表明,rTMS 治疗对氧化应激引起的细胞损伤具有神经保护作用,这在神经疾病的发病机制中起着重要作用。rTMS 治疗减轻了链脲佐菌素(STZ)诱导的神经元细胞死亡和 AD 样病理学。在 STZ 脑室注射引起的散发性 AD 动物模型中,rTMS 应用改善了认知能力下降,并对海马组织学表现出神经保护作用。总体而言,这项研究将有助于设计 rTMS 应用的刺激方案,并提出一种新的机制,可能解释 rTMS 在神经退行性疾病(包括 AD)中的治疗效果。