Aggarwal Arnav, Mendoza-Mari Yssel, Agrawal Devendra K
Loveless Academic Magnet Program, Montgomery, AL, USA.
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA.
J Biotechnol Biomed. 2024;7(4):453-470. doi: 10.26502/jbb.2642-91280169. Epub 2024 Nov 14.
Traumatic brain injury (TBI) is one of the growing public health problems and a leading cause of disabilities and mortality worldwide. After the mechanical impact to the head, patients of all ages suffer from cognitive and neurological deficits, as well as psychological disorders to different extents. In the last years, the use of electrical impulses and magnetic currents to achieve therapeutic effects have shown promising results and became potential treatments for TBI. Potential mechanisms of action described so far include long term potentiation and depression of neuronal synapses, stimulation of neurotransmitters and growth factors release, and reduction of neuroinflammation, apoptosis and excitotoxicity, among others. Although promising results have been obtained in pre-clinical experiments and limited clinical studies, the high rate of variability in technical parameters and the limited number of patients enrolled have made difficult to clearly define the optimal conditions to obtain reliable therapeutic effects with these stimulation techniques in TBI patients. The present review aims to describe the molecular processes taking place in the brain after the injury, as well as to describe some of the neurostimulation treatments currently under development for TBI management.
创伤性脑损伤(TBI)是一个日益严重的公共卫生问题,也是全球致残和致死的主要原因之一。头部受到机械撞击后,各年龄段的患者都会在不同程度上出现认知和神经功能缺损,以及心理障碍。近年来,利用电脉冲和磁流来实现治疗效果已显示出有前景的结果,并成为治疗TBI的潜在方法。目前描述的潜在作用机制包括神经元突触的长期增强和抑制、神经递质和生长因子释放的刺激,以及神经炎症、细胞凋亡和兴奋性毒性的减少等。尽管在临床前实验和有限的临床研究中已取得了有前景的结果,但技术参数的高变异性和纳入患者数量有限使得难以明确界定在TBI患者中使用这些刺激技术获得可靠治疗效果的最佳条件。本综述旨在描述损伤后大脑中发生的分子过程,以及描述目前正在开发的一些用于TBI管理的神经刺激治疗方法。
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