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Mapping the Iceberg of Autonomic Recovery: Mechanistic Underpinnings of Neuromodulation following Spinal Cord Injury. 绘制自主神经恢复的冰山:脊髓损伤后神经调节的机制基础。
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-06-01 Epub Date: 2023-01-11 DOI: 10.1177/10738584221145570
Soshi Samejima, Claire Shackleton, Tiev Miller, Chet T Moritz, Thomas M Kessler, Klaus Krogh, Rahul Sachdeva, Andrei V Krassioukov

Spinal cord injury leads to disruption in autonomic control resulting in cardiovascular, bowel, and lower urinary tract dysfunctions, all of which significantly reduce health-related quality of life. Although spinal cord stimulation shows promise for promoting autonomic recovery, the underlying mechanisms are unclear. Based on current preclinical and clinical evidence, this narrative review provides the most plausible mechanisms underlying the effects of spinal cord stimulation for autonomic recovery, including activation of the somatoautonomic reflex and induction of neuroplastic changes in the spinal cord. Areas where evidence is limited are highlighted in an effort to guide the scientific community to further explore these mechanisms and advance the clinical translation of spinal cord stimulation for autonomic recovery.

脊髓损伤会导致自律神经控制紊乱,造成心血管、肠道和下尿路功能障碍,所有这些都会大大降低与健康相关的生活质量。虽然脊髓刺激有望促进自律神经的恢复,但其潜在机制尚不清楚。根据目前的临床前和临床证据,本综述提供了脊髓刺激促进自律神经恢复的最合理机制,包括激活躯体自律神经反射和诱导脊髓神经可塑性变化。文中强调了证据有限的领域,旨在引导科学界进一步探索这些机制,推动脊髓刺激促进自律神经恢复的临床转化。
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引用次数: 0
The Mesencephalic Locomotor Region: Multiple Cell Types, Multiple Behavioral Roles, and Multiple Implications for Disease. 间脑运动区:多种细胞类型、多种行为作用和对疾病的多种影响。
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-06-01 Epub Date: 2022-12-28 DOI: 10.1177/10738584221139136
Dimitri Ryczko

The mesencephalic locomotor region (MLR) controls locomotion in vertebrates. In humans with Parkinson disease, locomotor deficits are increasingly associated with decreased activity in the MLR. This brainstem region, commonly considered to include the cuneiform and pedunculopontine nuclei, has been explored as a target for deep brain stimulation to improve locomotor function, but the results are variable, from modest to promising. However, the MLR is a heterogeneous structure, and identification of the best cell type to target is only beginning. Here, I review the studies that uncovered the role of genetically defined MLR cell types, and I highlight the cells whose activation improves locomotor function in animal models of Parkinson disease. The promising cell types to activate comprise some glutamatergic neurons in the cuneiform and caudal pedunculopontine nuclei, as well as some cholinergic neurons of the pedunculopontine nucleus. Activation of MLR GABAergic neurons should be avoided, since they stop locomotion or evoke bouts flanked with numerous stops. MLR is also considered a potential target in spinal cord injury, supranuclear palsy, primary progressive freezing of gait, or stroke. Better targeting of the MLR cell types should be achieved through optimized deep brain stimulation protocols, pharmacotherapy, or the development of optogenetics for human use.

间脑运动区(MLR)控制着脊椎动物的运动。在帕金森病患者中,运动障碍越来越多地与间脑运动区活动减少有关。这一脑干区域通常被认为包括楔状核和足底核,已被探索作为深部脑刺激的目标,以改善运动功能,但结果各不相同,有的效果一般,有的则很有希望。然而,MLR 是一种异质结构,确定最佳靶向细胞类型的工作才刚刚开始。在此,我回顾了揭示基因定义的 MLR 细胞类型的作用的研究,并重点介绍了激活后可改善帕金森病动物模型运动功能的细胞。有望激活的细胞类型包括楔状核和尾部足突核中的一些谷氨酸能神经元,以及足突核中的一些胆碱能神经元。应避免激活 MLR GABA 能神经元,因为它们会使运动停止或诱发多次停止的阵发性运动。MLR 也被认为是脊髓损伤、核上性麻痹、原发性进行性步态冻结或中风的潜在靶点。应通过优化脑深部刺激方案、药物疗法或开发供人类使用的光遗传学来更好地靶向 MLR 细胞类型。
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引用次数: 0
Threat Memory in the Sensory Cortex: Insights from Olfaction. 感觉皮层中的威胁记忆:来自嗅觉的启示。
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-06-01 Epub Date: 2023-01-26 DOI: 10.1177/10738584221148994
Wen Li, Donald A Wilson

The amygdala has long held the center seat in the neural basis of threat conditioning. However, a rapidly growing literature has elucidated extra-amygdala circuits in this process, highlighting the sensory cortex for its critical role in the mnemonic aspect of the process. While this literature is largely focused on the auditory system, substantial human and rodent findings on the olfactory system have emerged. The unique nature of the olfactory neuroanatomy and its intimate association with emotion compels a review of this recent literature to illuminate its special contribution to threat memory. Here, integrating recent evidence in humans and animal models, we posit that the olfactory (piriform) cortex is a primary and necessary component of the distributed threat memory network, supporting mnemonic ensemble coding of acquired threat. We further highlight the basic circuit architecture of the piriform cortex characterized by distributed, auto-associative connections, which is prime for highly efficient content-addressable memory computing to support threat memory. Given the primordial role of the piriform cortex in cortical evolution and its simple, well-defined circuits, we propose that olfaction can be a model system for understanding (transmodal) sensory cortical mechanisms underlying threat memory.

长期以来,杏仁核在威胁条件反射的神经基础中一直占据中心位置。然而,越来越多的文献阐明了这一过程中杏仁核以外的回路,强调了感觉皮层在这一过程的记忆方面所起的关键作用。虽然这些文献主要集中于听觉系统,但也出现了大量关于嗅觉系统的人类和啮齿动物研究成果。由于嗅觉神经解剖学的独特性及其与情感的密切联系,我们不得不对这些最新文献进行回顾,以阐明其对威胁记忆的特殊贡献。在此,我们综合了人类和动物模型的最新证据,认为嗅觉(梨状皮层)是分布式威胁记忆网络的主要和必要组成部分,支持对获得的威胁进行记忆性集合编码。我们进一步强调了以分布式自动关联连接为特征的梨状皮层基本电路结构,它是支持威胁记忆的高效内容可寻址记忆计算的首要条件。鉴于梨状皮层在皮层进化中的原始作用及其简单、定义明确的电路,我们建议将嗅觉作为一个模型系统,用于理解威胁记忆的(跨模态)感觉皮层机制。
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引用次数: 0
Genetics and Molecular Biology of Memory Suppression. 记忆抑制的遗传学和分子生物学。
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-06-01 Epub Date: 2022-12-15 DOI: 10.1177/10738584221138527
Nathaniel C Noyes, Ronald L Davis

The brain is designed not only with molecules and cellular processes that help to form memories but also with molecules and cellular processes that suppress the formation and retention of memory. The latter processes are critical for an efficient memory management system, given the vast amount of information that each person experiences in their daily activities and that most of this information becomes irrelevant with time. Thus, efficiency dictates that the brain should have processes for selecting the most critical information for storage and suppressing the irrelevant or forgetting it later should it escape the initial filters. Such memory suppressor molecules and processes are revealed by genetic or pharmacologic insults that lead to enhanced memory expression. We review here the predominant memory suppressor molecules and processes that have recently been discovered. They are diverse, as expected, because the brain is complex and employs many different strategies and mechanisms to form memories. They include the gene-repressive actions of small noncoding RNAs, repressors of protein synthesis, cAMP-mediated gene expression pathways, inter- and intracellular signaling pathways for normal forgetting, and others. A deep understanding of memory suppressor molecules and processes is necessary to fully comprehend how the brain forms, stabilizes, and retrieves memories and to reveal how brain disorders disrupt memory.

大脑不仅设计有助于形成记忆的分子和细胞过程,还设计有抑制记忆形成和保留的分子和电池过程。考虑到每个人在日常活动中经历的大量信息,以及这些信息中的大部分与时间无关,后一个过程对于高效的记忆管理系统至关重要。因此,效率决定了大脑应该有选择最关键信息进行存储的过程,并抑制不相关的信息,或者在以后逃离最初的过滤器时忘记这些信息。这种记忆抑制分子和过程是通过遗传或药理学损伤来揭示的,这些损伤导致记忆表达增强。我们在此回顾最近发现的主要记忆抑制分子和过程。正如预期的那样,它们是多样化的,因为大脑是复杂的,并采用许多不同的策略和机制来形成记忆。它们包括小的非编码RNA的基因抑制作用、蛋白质合成的抑制剂、cAMP介导的基因表达途径、正常遗忘的细胞间和细胞内信号通路等。深入了解记忆抑制分子和过程对于充分理解大脑如何形成、稳定和检索记忆以及揭示大脑疾病如何破坏记忆是必要的。
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引用次数: 0
Transfer of Tactile Learning to Untrained Body Parts: Emerging Cortical Mechanisms. 将触觉学习转移到未经训练的身体部位:新出现的皮层机制
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-05-30 DOI: 10.1177/10738584241256277
Sebastian M Frank

Pioneering investigations in the mid-19th century revealed that the perception of tactile cues presented to the surface of the skin improves with training, which is referred to as tactile learning. Surprisingly, tactile learning also occurs for body parts and skin locations that are not physically involved in the training. For example, after training of a finger, tactile learning transfers to adjacent untrained fingers. This suggests that the transfer of tactile learning follows a somatotopic pattern and involves brain regions such as the primary somatosensory cortex (S1), in which the trained and untrained body parts and skin locations are represented close to each other. However, other results showed that transfer occurs between body parts that are not represented close to each other in S1-for example, between the hand and the foot. These and similar findings have led to the suggestion of additional cortical mechanisms to explain the transfer of tactile learning. Here, different mechanisms are reviewed, and the extent to which they can explain the transfer of tactile learning is discussed. What all of these mechanisms have in common is that they assume a representational or functional relationship between the trained and untrained body parts and skin locations. However, none of these mechanisms alone can explain the complex pattern of transfer results, and it is likely that different mechanisms interact to enable transfer, perhaps in concert with higher somatosensory and decision-making areas.

19 世纪中叶的开创性研究表明,对皮肤表面触觉线索的感知会随着训练的进行而提高,这被称为触觉学习。令人惊讶的是,触觉学习也会发生在没有参与训练的身体部位和皮肤位置。例如,在对手指进行训练后,触觉学习会转移到相邻的未经训练的手指上。这表明,触觉学习的迁移遵循体位模式,涉及初级体感皮层(S1)等脑区,在这些脑区中,受过训练和未受过训练的身体部位和皮肤位置彼此靠近。然而,其他研究结果表明,迁移发生在身体部位之间,而这些部位在 S1 中的表现并不接近--例如,在手和脚之间。这些研究结果和类似的研究结果促使人们提出了更多的皮层机制来解释触觉学习的迁移。在此,我们将对不同的机制进行回顾,并讨论它们在多大程度上可以解释触觉学习的迁移。所有这些机制的共同点是,它们都假定训练过和未训练过的身体部位和皮肤位置之间存在表征或功能关系。然而,这些机制都无法单独解释复杂的迁移结果模式,很可能是不同的机制相互作用促成了迁移,也许是与高级躯体感觉和决策区域协同作用。
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引用次数: 0
Microglia, Trem2, and Neurodegeneration. 小胶质细胞、Trem2 和神经退行性变
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-05-20 DOI: 10.1177/10738584241254118
Qian Shi, Raul A Gutierrez, Manzoor A Bhat

Microglia are a specialized type of neuroimmune cells that undergo morphological and molecular changes through multiple signaling pathways in response to pathological protein aggregates, neuronal death, tissue injury, or infections. Microglia express Trem2, which serves as a receptor for a multitude of ligands enhancing their phagocytic activity. Trem2 has emerged as a critical modulator of microglial activity, especially in many neurodegenerative disorders. Human TREM2 mutations are associated with an increased risk of developing Alzheimer disease (AD) and other neurodegenerative diseases. Trem2 plays dual roles in neuroinflammation and more specifically in disease-associated microglia. Most recent developments on the molecular mechanisms of Trem2, emphasizing its role in uptake and clearance of amyloid β (Aβ) aggregates and other tissue debris to help protect and preserve the brain, are encouraging. Although Trem2 normally stimulates defense mechanisms, its dysregulation can intensify inflammation, which poses major therapeutic challenges. Recent therapeutic approaches targeting Trem2 via agonistic antibodies and gene therapy methodologies present possible avenues for reducing the burden of neurodegenerative diseases. This review highlights the promise of Trem2 as a therapeutic target, especially for Aβ-associated AD, and calls for more mechanistic investigations to understand the context-specific role of microglial Trem2 in developing effective therapies against neurodegenerative diseases.

小胶质细胞是一种特化的神经免疫细胞,在病理蛋白聚集、神经元死亡、组织损伤或感染的情况下,它们会通过多种信号通路发生形态和分子变化。小胶质细胞表达 Trem2,它是多种配体的受体,能增强小胶质细胞的吞噬活性。Trem2 已成为小胶质细胞活性的关键调节因子,尤其是在许多神经退行性疾病中。人类 TREM2 基因突变与阿尔茨海默病(AD)和其他神经退行性疾病的患病风险增加有关。Trem2 在神经炎症中扮演着双重角色,尤其是在疾病相关的小胶质细胞中。关于 Trem2 分子机制的最新进展令人鼓舞,这些进展强调了 Trem2 在摄取和清除淀粉样蛋白 β(Aβ)聚集体和其他组织碎片以帮助保护和保存大脑方面的作用。虽然 Trem2 通常会刺激防御机制,但其失调会加剧炎症,这给治疗带来了重大挑战。最近通过激动抗体和基因治疗方法靶向 Trem2 的治疗方法为减轻神经退行性疾病的负担提供了可能的途径。这篇综述强调了 Trem2 作为治疗靶点的前景,尤其是对于 Aβ 相关性注意力缺失症,并呼吁开展更多的机理研究,以了解小胶质细胞 Trem2 在开发针对神经退行性疾病的有效疗法中的特定作用。
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引用次数: 0
Adult Hippocampal Neurogenesis in the Human Brain: Updates, Challenges, and Perspectives. 人脑中的成年海马神经发生:最新进展、挑战和前景》。
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-05-17 DOI: 10.1177/10738584241252581
Sophie Simard, Natalie Matosin, Naguib Mechawar

The existence of neurogenesis in the adult human hippocampus has been under considerable debate within the past three decades due to the diverging conclusions originating mostly from immunohistochemistry studies. While some of these reports conclude that hippocampal neurogenesis in humans occurs throughout physiologic aging, others indicate that this phenomenon ends by early childhood. More recently, some groups have adopted next-generation sequencing technologies to characterize with more acuity the extent of this phenomenon in humans. Here, we review the current state of research on adult hippocampal neurogenesis in the human brain with an emphasis on the challenges and limitations of using immunohistochemistry and next-generation sequencing technologies for its study.

在过去的三十年中,由于主要来自免疫组化研究的不同结论,关于成年人类海马神经发生的存在一直存在很大争议。其中一些报告得出结论认为,人类海马的神经发生贯穿整个生理衰老过程,而另一些报告则指出,这种现象在儿童早期就已经结束。最近,一些研究小组采用了下一代测序技术,以更清晰地描述这一现象在人类中的程度。在此,我们回顾了人脑中成年海马神经发生的研究现状,重点介绍了使用免疫组化和新一代测序技术进行研究的挑战和局限性。
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引用次数: 0
Gustav Oppenheim (1882-1937) and the Discovery of Cerebral Amyloid Angiopathy. 古斯塔夫-奥本海姆(1882-1937 年)与脑淀粉样血管病的发现。
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-05-14 DOI: 10.1177/10738584241251828
Anthony Maurice Ness, Judd Aiken

The discovery of cerebral amyloid angiopathy (CAA) is frequently attributed to Dr. Gustav Oppenheim-a man who has been largely passed over in history. Oppenheim's clinical and neuropathologic research covered a variety of disorders, but his name is best known for his work on senile dementia and CAA. Although Oppenheim was in fact not the first to discover CAA, his neuropathologic observations and inferences on neurodegenerative disease proved to be remarkably faithful to our modern understanding of neurodegenerative diseases. As a neurologist, he served in the First World War and was later subjected to religious persecutions in the leadup to the Holocaust but was not fortunate enough to emigrate before his death. The life, social impact, and previously overlooked contributions to science and medicine by Oppenheim are detailed.

脑淀粉样血管病(CAA)的发现常常归功于古斯塔夫-奥本海姆(Gustav Oppenheim)博士--一个在历史上被忽略的人。奥本海姆的临床和神经病理学研究涉及多种疾病,但他的名字因研究老年痴呆症和 CAA 而最为人熟知。虽然奥本海姆事实上并不是第一个发现 CAA 的人,但他对神经退行性疾病的神经病理学观察和推断,被证明非常忠实于我们现代对神经退行性疾病的理解。作为一名神经病学家,他参加了第一次世界大战,后来在大屠杀前夕受到宗教迫害,但生前没有幸运地移居国外。书中详细介绍了奥本海姆的生平、社会影响以及以前被忽视的对科学和医学的贡献。
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引用次数: 0
Oxygen and the Spark of Human Brain Evolution: Complex Interactions of Metabolism and Cortical Expansion across Development and Evolution. 氧气与人类大脑进化的火花:新陈代谢与皮质扩展在发育和进化过程中的复杂互动。
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-01 Epub Date: 2022-12-08 DOI: 10.1177/10738584221138032
Andrea I Luppi, Fernando E Rosas, MaryAnn P Noonan, Pedro A M Mediano, Morten L Kringelbach, Robin L Carhart-Harris, Emmanuel A Stamatakis, Anthony C Vernon, Federico E Turkheimer

Scientific theories on the functioning and dysfunction of the human brain require an understanding of its development-before and after birth and through maturation to adulthood-and its evolution. Here we bring together several accounts of human brain evolution by focusing on the central role of oxygen and brain metabolism. We argue that evolutionary expansion of human transmodal association cortices exceeded the capacity of oxygen delivery by the vascular system, which led these brain tissues to rely on nonoxidative glycolysis for additional energy supply. We draw a link between the resulting lower oxygen tension and its effect on cytoarchitecture, which we posit as a key driver of genetic developmental programs for the human brain-favoring lower intracortical myelination and the presence of biosynthetic materials for synapse turnover. Across biological and temporal scales, this protracted capacity for neural plasticity sets the conditions for cognitive flexibility and ongoing learning, supporting complex group dynamics and intergenerational learning that in turn enabled improved nutrition to fuel the metabolic costs of further cortical expansion. Our proposed model delineates explicit mechanistic links among metabolism, molecular and cellular brain heterogeneity, and behavior, which may lead toward a clearer understanding of brain development and its disorders.

关于人脑功能和失调的科学理论需要了解人脑的发育--从出生前到出生后,从成熟到成年--及其进化过程。在这里,我们通过关注氧气和大脑新陈代谢的核心作用,汇集了关于人脑进化的几种说法。我们认为,人类跨模态关联皮层的进化扩张超过了血管系统的供氧能力,这导致这些脑组织依赖非氧化糖酵解来提供额外能量。我们将由此导致的较低氧张力及其对细胞结构的影响联系起来,并认为这是人类大脑遗传发育程序的一个关键驱动因素--它有利于降低皮层内的髓鞘化程度,并有利于突触周转所需的生物合成材料的存在。在整个生物和时间尺度上,这种神经可塑性的长期能力为认知灵活性和持续学习创造了条件,支持复杂的群体动力学和代际学习,而代际学习反过来又使营养得到改善,从而为皮质进一步扩张的代谢成本提供燃料。我们提出的模型在新陈代谢、分子和细胞大脑异质性以及行为之间建立了明确的机理联系,这可能有助于人们更清楚地了解大脑发育及其疾病。
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引用次数: 0
Ask the dust. 问尘埃。
IF 5.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-01 DOI: 10.1177/10738584241236158
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引用次数: 0
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