Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili di Brescia, Brescia, Italy.
J Alzheimers Dis. 2024;101(s1):S545-S565. doi: 10.3233/JAD-230535.
Alzheimer's disease (AD) continues to lack definitive curative therapies, necessitating an urgent exploration of innovative approaches. This review provides a comprehensive analysis of recent clinical trials focusing on invasive and non-invasive brain stimulation techniques as potential interventions for AD. Deep brain stimulation (DBS), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and transcranial alternating current stimulation (tACS) are evaluated for their therapeutic efficacy, safety, and applicability. DBS, though invasive, has shown promising results in mitigating cognitive decline, but concerns over surgical risks and long-term effects persist. On the other hand, non-invasive methods like rTMS, tDCS, and tACS have demonstrated potential in enhancing cognitive performance and delaying disease progression, with minimal side effects, but with varied consistency. The evidence hints towards an individualized, patient-centric approach to brain stimulation, considering factors such as disease stage, genetic traits, and stimulation parameters. The review also highlights emerging technologies and potential future directions, emphasizing the need for larger, multi-center trials to confirm preliminary findings and establish robust clinical guidelines. In conclusion, while brain stimulation techniques present a promising avenue in AD therapy, further research is imperative for more comprehensive understanding and successful clinical implementation. Through this review, we aim to catalyze the scientific discourse and stimulate further investigation into these novel interventions for AD.
阿尔茨海默病（AD）目前仍然缺乏明确的治疗方法，因此需要迫切探索创新的方法。本综述全面分析了最近针对侵袭性和非侵袭性脑刺激技术的临床试验，这些技术可能是 AD 的潜在干预手段。对深部脑刺激（DBS）、重复经颅磁刺激（rTMS）、经颅直流电刺激（tDCS）和经颅交流电刺激（tACS）的治疗效果、安全性和适用性进行了评估。DBS 虽然具有侵袭性，但在减轻认知能力下降方面显示出了有希望的结果，但对手术风险和长期影响的担忧仍然存在。另一方面，像 rTMS、tDCS 和 tACS 等非侵入性方法在提高认知表现和延缓疾病进展方面表现出了潜力，且副作用较小，但一致性存在差异。这些证据表明，应该考虑到疾病阶段、遗传特征和刺激参数等因素，采用个体化、以患者为中心的脑刺激方法。该综述还强调了新兴技术和潜在的未来方向，强调需要进行更大规模、多中心的试验来确认初步发现并建立稳健的临床指南。总之，尽管脑刺激技术在 AD 治疗中展现出了广阔的前景，但为了更全面地理解和成功地将其应用于临床，还需要进一步的研究。通过本综述，我们旨在推动科学界的讨论，并激发对这些 AD 新型干预手段的进一步研究。
