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Assessment of Potential Targets for Deep Brain Stimulation in Patients With Alzheimer’s Disease

机译:评估阿尔茨海默氏病患者深层脑刺激的潜在目标

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摘要

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder affecting 36 million people worldwide and 5.2 million in the United States. The pathogenesis of AD is still elusive. Accumulations of abnormal proteins (beta amyloid and tau protein), inflammatory cascades, abnormal responses to oxidative stress and alteration in oxidative metabolism have been implicated in AD. There are few effective therapeutic options available for this disorder at present. Neuromodulation offers a novel treatment modality for patients with AD. The databases of Medline and PubMed were searched for various studies in English literature describing the deep brain stimulation (DBS) in patients with AD. Various animal and human clinical studies have shown promising initial results with bilateral DBS targeting various anatomical nodes. In this review, we attempt to highlight the pathophysiology, neural circuitry and potential neuromodulation options in patients with AD. In appropriately selected patients, DBS can potentially delay the cognitive decline, enhance memory functions and can improve the overall quality of life. However, further randomized controlled trials are required to validate the efficacy of neuromodulation and to determine the most optimal target for AD.
机译:阿尔茨海默氏病(AD)是一种进行性神经退行性疾病,影响全世界3,600万人和美国520万人。 AD的发病机制仍然难以捉摸。 AD中涉及异常蛋白(β淀粉样蛋白和tau蛋白)的积累,炎性级联,对氧化应激的异常反应和氧化代谢的改变。目前,针对该疾病的有效治疗选择很少。神经调节为AD患者提供了一种新颖的治疗方式。在Medline和PubMed的数据库中搜索了英语文献中描述AD患者深部脑刺激(DBS)的各种研究。各种动物和人类临床研究均显示了针对各种解剖结节的双侧DBS有望获得初步结果。在这篇综述中,我们试图强调AD患者的病理生理,神经回路和潜在的神经调节选择。在适当选择的患者中,DBS可能会延迟认知能力下降,增强记忆功能并改善整体生活质量。但是,还需要进一步的随机对照试验来验证神经调节的功效并确定AD的最佳靶点。

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