Cognitive and Neuropathophysiological Outcomes of Gamma-tACS in Dementia: A Systematic Review.

IF 5.4 2区 心理学 Q1 NEUROSCIENCES Neuropsychology Review Pub Date : 2024-03-01 Epub Date: 2023-03-06 DOI:10.1007/s11065-023-09589-0
Valerio Manippa, Annalisa Palmisano, Michael A Nitsche, Marco Filardi, Davide Vilella, Giancarlo Logroscino, Davide Rivolta
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Abstract

Despite the numerous pharmacological interventions targeting dementia, no disease-modifying therapy is available, and the prognosis remains unfavorable. A promising perspective involves tackling high-frequency gamma-band (> 30 Hz) oscillations involved in hippocampal-mediated memory processes, which are impaired from the early stages of typical Alzheimer's Disease (AD). Particularly, the positive effects of gamma-band entrainment on mouse models of AD have prompted researchers to translate such findings into humans using transcranial alternating current stimulation (tACS), a methodology that allows the entrainment of endogenous cortical oscillations in a frequency-specific manner. This systematic review examines the state-of-the-art on the use of gamma-tACS in Mild Cognitive Impairment (MCI) and dementia patients to shed light on its feasibility, therapeutic impact, and clinical effectiveness. A systematic search from two databases yielded 499 records resulting in 10 included studies and a total of 273 patients. The results were arranged in single-session and multi-session protocols. Most of the studies demonstrated cognitive improvement following gamma-tACS, and some studies showed promising effects of gamma-tACS on neuropathological markers, suggesting the feasibility of gamma-tACS in these patients anyhow far from the strong evidence available for mouse models. Nonetheless, the small number of studies and their wide variability in terms of aims, parameters, and measures, make it difficult to draw firm conclusions. We discuss results and methodological limitations of the studies, proposing possible solutions and future avenues to improve research on the effects of gamma-tACS on dementia.

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伽马-tACS 治疗痴呆症的认知和神经病理生理学结果:系统回顾
尽管针对痴呆症的药物干预措施层出不穷,但目前尚无改变病情的疗法,预后仍然不容乐观。一种前景广阔的方法是研究海马介导的记忆过程中涉及的高频伽马波段(大于 30 赫兹)振荡,这种振荡在典型的阿尔茨海默病(AD)早期阶段就已受损。尤其是伽马波段夹带对小鼠 AD 模型的积极影响,促使研究人员利用经颅交变电流刺激(tACS)将这些发现转化到人类身上,这种方法允许以特定频率的方式夹带内源性皮质振荡。这篇系统性综述研究了伽马经颅交流电刺激在轻度认知障碍(MCI)和痴呆症患者中的最新应用,以阐明其可行性、治疗效果和临床有效性。通过对两个数据库进行系统检索,共获得 499 条记录,其中包括 10 项研究和 273 名患者。研究结果分为单疗程和多疗程方案。大多数研究显示,伽马-tACS治疗后患者的认知能力有所改善,一些研究还显示伽马-tACS对神经病理学标志物有很好的疗效,这表明伽马-tACS在这些患者中的可行性与小鼠模型的有力证据相去甚远。尽管如此,由于研究数量少,而且在目的、参数和测量方法上存在很大差异,因此很难得出确切的结论。我们讨论了这些研究的结果和方法上的局限性,提出了可能的解决方案和未来的途径,以改进伽马-tACS对痴呆症影响的研究。
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来源期刊
Neuropsychology Review
Neuropsychology Review 医学-神经科学
CiteScore
11.00
自引率
1.70%
发文量
36
期刊介绍: Neuropsychology Review is a quarterly, refereed publication devoted to integrative review papers on substantive content areas in neuropsychology, with particular focus on populations with endogenous or acquired conditions affecting brain and function and on translational research providing a mechanistic understanding of clinical problems. Publication of new data is not the purview of the journal. Articles are written by international specialists in the field, discussing such complex issues as distinctive functional features of central nervous system disease and injury; challenges in early diagnosis; the impact of genes and environment on function; risk factors for functional impairment; treatment efficacy of neuropsychological rehabilitation; the role of neuroimaging, neuroelectrophysiology, and other neurometric modalities in explicating function; clinical trial design; neuropsychological function and its substrates characteristic of normal development and aging; and neuropsychological dysfunction and its substrates in neurological, psychiatric, and medical conditions. The journal''s broad perspective is supported by an outstanding, multidisciplinary editorial review board guided by the aim to provide students and professionals, clinicians and researchers with scholarly articles that critically and objectively summarize and synthesize the strengths and weaknesses in the literature and propose novel hypotheses, methods of analysis, and links to other fields.
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