Department of Clinical Physiology of Vision, Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia.
Department of Pathology of the Retina and Optic Nerve, Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia.
Adv Neurobiol. 2024;36:585-637. doi: 10.1007/978-3-031-47606-8_31.
The neuroplasticity potential is reduced with aging and impairs during neurodegenerative diseases and brain and visual system injuries. This limits the brain's capacity to repair the structure and dynamics of its activity after lesions. Maximization of neuroplasticity is necessary to provide the maximal CNS response to therapeutic intervention and adaptive reorganization of neuronal networks in patients with degenerative pathology and traumatic injury to restore the functional activity of the brain and retina.Considering the fractal geometry and dynamics of the healthy brain and the loss of fractality in neurodegenerative pathology, we suggest that the application of self-similar visual signals with a fractal temporal structure in the stimulation therapy can reactivate the adaptive neuroplasticity and enhance the effectiveness of neurorehabilitation. This proposition was tested in the recent studies. Patients with glaucoma had a statistically significant positive effect of fractal photic therapy on light sensitivity and the perimetric MD index, which shows that methods of fractal stimulation can be a novel nonpharmacological approach to neuroprotective therapy and neurorehabilitation. In healthy rabbits, it was demonstrated that a long-term course of photostimulation with fractal signals does not harm the electroretinogram (ERG) and retina structure. Rabbits with modeled retinal atrophy showed better dynamics of the ERG restoration during daily stimulation therapy for a week in comparison with the controls. Positive changes in the retinal function can indirectly suggest the activation of its adaptive plasticity and the high potential of stimulation therapy with fractal visual stimuli in a nonpharmacological neurorehabilitation, which requires further study.
神经可塑性随着年龄的增长而降低，并在神经退行性疾病和脑及视觉系统损伤期间受损。这限制了大脑在损伤后修复其结构和活动动态的能力。最大限度地提高神经可塑性对于为治疗干预提供最大的中枢神经系统反应以及在退行性病变和创伤性损伤的患者中实现神经元网络的适应性重组以恢复大脑和视网膜的功能活动是必要的。考虑到健康大脑的分形几何和动力学以及神经退行性病变中分形性的丧失，我们提出在刺激治疗中应用具有分形时间结构的自相似视觉信号可以重新激活适应性神经可塑性并增强神经康复的效果。这一假设在最近的研究中得到了检验。青光眼患者的分形光疗对光敏感度和周边 MD 指数有统计学上的显著积极影响，这表明分形刺激方法可以成为神经保护治疗和神经康复的一种新的非药物方法。在健康兔子中，证明了长期接受分形信号的光刺激不会损害视网膜电图（ERG）和视网膜结构。与对照组相比，在一周的日常刺激治疗期间，模拟视网膜萎缩的兔子的 ERG 恢复动态更好。视网膜功能的阳性变化可以间接表明其适应性可塑性的激活和分形视觉刺激在非药物神经康复中的刺激治疗的高潜力，这需要进一步研究。
