从分子到患者康复:经颅直流电刺激和磁刺激对脑卒中的影响——叙述性综述。

IF 3 4区 医学 Q2 NEUROSCIENCES Neural Plasticity Pub Date : 2023-01-01 DOI:10.1155/2023/5044065
Anca Badoiu, Smaranda Ioana Mitran, Bogdan Catalin, Tudor Adrian Balseanu, Aurel Popa-Wagner, Florin Liviu Gherghina, Carmen Valeria Albu, Raluca Elena Sandu
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引用次数: 2

摘要

中风是世界范围内的一个主要健康问题,对幸存者及其家属具有许多健康、社会和经济影响。解决这一问题的一个简单办法是确保最好的康复,并充分重新融入社会。因此,医疗保健专业人员开发和使用了大量的康复计划。其中,经颅磁刺激和经颅直流电刺激等现代技术正在使用,似乎可以改善脑卒中后的康复。这一成功归功于它们增强细胞神经调节的能力。这种调节包括炎症反应的减少、自噬抑制、抗凋亡作用、血管生成的增强、血脑屏障通透性的改变、氧化应激的衰减、对神经递质代谢的影响、神经发生和结构神经可塑性的增强。在细胞水平的动物模型和临床研究中证实了这种有利作用。因此,这些方法被证明可以减少梗死面积,改善运动表现、吞咽、功能独立性和高阶脑功能(即失语和半疏忽)。然而,与每一种治疗方法一样,这些技术也有局限性。它们的给药方案,它们应用的中风阶段,以及患者的特征(即基因型和皮质脊髓完整性)似乎会影响结果。因此,在动物脑卒中模型研究和临床试验中,在某些情况下均无反应,甚至出现恶化。总的来说,权衡风险和收益,新的经颅电和磁刺激技术可以成为改善中风后患者恢复的有效工具,副作用最小甚至没有。在这里,我们讨论他们的作用和分子和细胞事件的影响,以及他们的临床意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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From Molecule to Patient Rehabilitation: The Impact of Transcranial Direct Current Stimulation and Magnetic Stimulation on Stroke-A Narrative Review.

Stroke is a major health problem worldwide, with numerous health, social, and economic implications for survivors and their families. One simple answer to this problem would be to ensure the best rehabilitation with full social reintegration. As such, a plethora of rehabilitation programs was developed and used by healthcare professionals. Among them, modern techniques such as transcranial magnetic stimulation and transcranial direct current stimulation are being used and seem to bring improvements to poststroke rehabilitation. This success is attributed to their capacity to enhance cellular neuromodulation. This modulation includes the reduction of the inflammatory response, autophagy suppression, antiapoptotic effects, angiogenesis enhancement, alterations in the blood-brain barrier permeability, attenuation of oxidative stress, influence on neurotransmitter metabolism, neurogenesis, and enhanced structural neuroplasticity. The favorable effects have been demonstrated at the cellular level in animal models and are supported by clinical studies. Thus, these methods proved to reduce infarct volumes and to improve motor performance, deglutition, functional independence, and high-order cerebral functions (i.e., aphasia and heminegligence). However, as with every therapeutic method, these techniques can also have limitations. Their regimen of administration, the phase of the stroke at which they are applied, and the patients' characteristics (i.e., genotype and corticospinal integrity) seem to influence the outcome. Thus, no response or even worsening effects were obtained under certain circumstances both in animal stroke model studies and in clinical trials. Overall, weighing up risks and benefits, the new transcranial electrical and magnetic stimulation techniques can represent effective tools with which to improve the patients' recovery after stroke, with minimal to no adverse effects. Here, we discuss their effects and the molecular and cellular events underlying their effects as well as their clinical implications.

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来源期刊
Neural Plasticity
Neural Plasticity NEUROSCIENCES-
CiteScore
6.80
自引率
0.00%
发文量
77
审稿时长
16 weeks
期刊介绍: Neural Plasticity is an international, interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology. Neural Plasticity publishes research and review articles from the entire range of relevant disciplines, including basic neuroscience, behavioral neuroscience, cognitive neuroscience, biological psychology, and biological psychiatry.
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