VanGilder Paul, Tanner Justin, Krull Kevin R, Sitaram Ranganatha
Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 262 Danny Thomas Pl, Memphis, TN 38105, USA.
Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Pl, Memphis, TN 38105, USA.
Brain Sci. 2024 Feb 27;14(3):218. doi: 10.3390/brainsci14030218.
Cancer survivors are at a high risk for treatment-related late effects, particularly neurocognitive impairment in the attention and executive function domains. These can be compounded in pediatric populations still undergoing neural development, which has increased interest in survivorship studies and neurorehabilitation approaches to mitigate these effects. Cognitive training regimens have shown promise as a therapeutic intervention for improving cognitive function. Therapist-guided and computerized training programs with adaptive paradigms have been successfully implemented in pediatric populations, with positive outcomes on attention and working memory. Another interventional approach is neuromodulation to alter plasticity. Transcranial electrical stimulation can modulate cortical surface activity, and cranial nerve stimulation alters autonomic activity in afferent brainstem pathways. However, they are more systemic in nature and have diffuse spatial targeting. Transcranial focused ultrasound (tFUS) modulation overcomes these limitations with high spatial specificity and the ability to target deeper brain regions. In this review, we discuss the efficacy of tFUS for modulating specific brain regions and its potential utility to augment cognitive training programs as a complementary intervention.
癌症幸存者面临与治疗相关的晚期效应的高风险，尤其是在注意力和执行功能领域的神经认知障碍。对于仍在经历神经发育的儿科人群来说，这些影响可能会更加复杂，这使得人们对生存研究和神经康复方法越来越感兴趣，以减轻这些影响。认知训练方案已显示出作为改善认知功能的治疗干预措施的前景。在儿科人群中，由治疗师指导的和具有自适应范式的计算机化训练方案已成功实施，并在注意力和工作记忆方面取得了积极成果。另一种干预方法是神经调节以改变可塑性。经颅电刺激可以调节皮质表面活动，而颅神经刺激可以改变传入脑干通路中的自主神经活动。然而，它们本质上更具全身性，且空间靶向性较分散。经颅聚焦超声（tFUS）调制克服了这些局限性，具有高空间特异性以及靶向更深脑区的能力。在本综述中，我们讨论了tFUS调节特定脑区的功效及其作为补充干预措施增强认知训练方案的潜在效用。
