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利用脑可塑性:重复经颅磁刺激(rTMS)和theta爆发刺激(TBS)在神经递质调节、受体动力学及神经成像中的治疗作用,以推动神经学创新

Harnessing Brain Plasticity: The Therapeutic Power of Repetitive Transcranial Magnetic Stimulation (rTMS) and Theta Burst Stimulation (TBS) in Neurotransmitter Modulation, Receptor Dynamics, and Neuroimaging for Neurological Innovations.

作者信息

Sharbafshaaer Minoo, Cirillo Giovanni, Esposito Fabrizio, Tedeschi Gioacchino, Trojsi Francesca

机构信息

First Division of Neurology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.

Division of Human Anatomy, Neuronal Networks Morphology & Systems Biology Lab, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli, 80138 Naples, Italy.

出版信息

Biomedicines. 2024 Nov 1;12(11):2506. doi: 10.3390/biomedicines12112506.

Abstract

Transcranial magnetic stimulation (TMS) methods have become exciting techniques for altering brain activity and improving synaptic plasticity, earning recognition as valuable non-medicine treatments for a wide range of neurological disorders. Among these methods, repetitive TMS (rTMS) and theta-burst stimulation (TBS) show significant promise in improving outcomes for adults with complex neurological and neurodegenerative conditions, such as Alzheimer's disease, stroke, Parkinson's disease, etc. However, optimizing their effects remains a challenge due to variability in how patients respond and a limited understanding of how these techniques interact with crucial neurotransmitter systems. This narrative review explores the mechanisms of rTMS and TBS, which enhance neuroplasticity and functional improvement. We specifically focus on their effects on GABAergic and glutamatergic pathways and how they interact with key receptors like N-Methyl-D-Aspartate (NMDA) and AMPA receptors, which play essential roles in processes like long-term potentiation (LTP) and long-term depression (LTD). Additionally, we investigate how rTMS and TBS impact neuroplasticity and functional connectivity, particularly concerning brain-derived neurotrophic factor (BDNF) and tropomyosin-related kinase receptor type B (TrkB). Here, we highlight the significant potential of this research to expand our understanding of neuroplasticity and better treatment outcomes for patients. Through clarifying the neurobiology mechanisms behind rTMS and TBS with neuroimaging findings, we aim to develop more effective, personalized treatment plans that effectively address the challenges posed by neurological disorders and ultimately enhance the quality of neurorehabilitation services and provide future directions for patients' care.

摘要

经颅磁刺激(TMS)方法已成为改变大脑活动和改善突触可塑性的令人兴奋的技术,被誉为治疗多种神经系统疾病的有价值的非药物疗法。在这些方法中,重复经颅磁刺激(rTMS)和theta爆发刺激(TBS)在改善患有复杂神经系统和神经退行性疾病(如阿尔茨海默病、中风、帕金森病等)的成年人的治疗效果方面显示出巨大潜力。然而,由于患者反应的变异性以及对这些技术如何与关键神经递质系统相互作用的了解有限,优化它们的效果仍然是一个挑战。这篇叙述性综述探讨了rTMS和TBS增强神经可塑性和功能改善的机制。我们特别关注它们对γ-氨基丁酸能(GABAergic)和谷氨酸能(glutamatergic)通路的影响,以及它们如何与N-甲基-D-天冬氨酸(NMDA)和α-氨基-3-羟基-5-甲基-4-异恶唑丙酸(AMPA)受体等关键受体相互作用,这些受体在长时程增强(LTP)和长时程抑制(LTD)等过程中起重要作用。此外,我们研究rTMS和TBS如何影响神经可塑性和功能连接,特别是关于脑源性神经营养因子(BDNF)和原肌球蛋白相关激酶受体B型(TrkB)。在此,我们强调这项研究在扩展我们对神经可塑性的理解以及为患者带来更好治疗效果方面的巨大潜力。通过用神经影像学研究结果阐明rTMS和TBS背后的神经生物学机制,我们旨在制定更有效、个性化的治疗方案,有效应对神经系统疾病带来的挑战,并最终提高神经康复服务的质量,为患者护理提供未来方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c39f/11592033/58cb16250f5b/biomedicines-12-02506-g001.jpg

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