McNerney M Windy, Gurkoff Gene G, Beard Charlotte, Berryhill Marian E
Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
Brain Sci. 2023 Sep 30;13(10):1402. doi: 10.3390/brainsci13101402.
Neurostimulation carries high therapeutic potential, accompanied by an excellent safety profile. In this review, we argue that an arena in which these tools could provide breakthrough benefits is traumatic brain injury (TBI). TBI is a major health problem worldwide, with the majority of cases identified as mild TBI (mTBI). MTBI is of concern because it is a modifiable risk factor for dementia. A major challenge in studying mTBI is its inherent across a large feature space (e.g., etiology, age of injury, sex, treatment, initial health status, etc.). Parallel lines of research in human and rodent mTBI can be collated to take advantage of the full suite of neuroscience tools, from neuroimaging (electroencephalography: EEG; functional magnetic resonance imaging: fMRI; diffusion tensor imaging: DTI) to biochemical assays. Despite these attractive components and the need for effective treatments, there are at least two major challenges to implementation. First, there is insufficient understanding of how neurostimulation alters neural mechanisms. Second, there is insufficient understanding of how mTBI alters neural function. The goal of this review is to assemble interrelated but disparate areas of research to identify important gaps in knowledge impeding the implementation of neurostimulation.
神经刺激具有很高的治疗潜力,且安全性良好。在本综述中,我们认为这些工具能够带来突破性益处的一个领域是创伤性脑损伤(TBI)。TBI是全球范围内的一个主要健康问题,大多数病例被认定为轻度TBI(mTBI)。mTBI令人担忧,因为它是痴呆症的一个可改变的风险因素。研究mTBI的一个主要挑战在于其在较大特征空间(如病因、受伤年龄、性别、治疗、初始健康状况等)中固有的变异性。人类和啮齿动物mTBI的平行研究路线可以整合起来,以利用从神经成像(脑电图:EEG;功能磁共振成像:fMRI;扩散张量成像:DTI)到生化检测等全套神经科学工具。尽管有这些吸引人的因素以及对有效治疗的需求,但实施方面至少存在两个主要挑战。第一,对神经刺激如何改变神经机制的了解不足。第二,对mTBI如何改变神经功能的了解不足。本综述的目的是汇集相互关联但又不同的研究领域,以找出阻碍神经刺激实施的重要知识空白。