For decades visual field defects were considered irreversible because it was thought that in the visual system the regeneration potential of the neuronal tissues is low.Nevertheless,there is always some potential for ...For decades visual field defects were considered irreversible because it was thought that in the visual system the regeneration potential of the neuronal tissues is low.Nevertheless,there is always some potential for partial recovery of the visual field defect that can be achieved through induction of neuroplasticity.Neuroplasticity refers to the ability of the brain to change its own functional architecture by modulating synaptic efficacy.It is maintained throughout life and just as neurological rehabilitation can improve motor coordination,visual field defects in glaucoma,diabetic retinopathy or optic neuropathy can be improved by inducing neuroplasticity.In ophthalmology many new treatment paradigms have been tested that can induce neuroplastic changes,including non-invasive alternating current stimulation.Treatment with alternating current stimulation(e.g.,30 minutes,daily for 10 days using transorbital electrodes and^10 Hz)activates the entire retina and parts of the brain.Electroencephalography and functional magnetic resonance imaging studies revealed local activation of the visual cortex,global reorganization of functional brain networks,and enhanced blood flow,which together activate neurons and their networks.The future of low vision is optimistic because vision loss is indeed,partially reversible.展开更多
Background:Transcranial alternating current stimulation(tACS)offers a new approach for adult patients with major depressive disorder(MDD).The study is to evaluate the efficacy and safety of tACS treating MDD.Methods:T...Background:Transcranial alternating current stimulation(tACS)offers a new approach for adult patients with major depressive disorder(MDD).The study is to evaluate the efficacy and safety of tACS treating MDD.Methods:This is an 8-week,double-blind,randomized,placebo-controlled study.Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min,77.5-Hz,15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks(week 4),following a 4-week observation period(week 8).The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale(HDRS-17)score≤7 at week 8.Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17,the proportion of participants having improvement in the clinical global impression-improvement,the change in HDRS-17 score(range,0-52,with higher scores indicating more depression)over the study,and variations of brain imaging and neurocognition from baseline to week 4.Safety will be assessed by vital signs at weeks 4 and 8,and adverse events will be collected during the entire study.Discussion:The tACS applied in this trial may have treatment effects on MDD with minimal side effects.Trial registration:Chinese Clinical Trial Registry,ChiCTR1800016479;http://www.chictr.org.cn/showproj.aspx?proj=22048.展开更多
Neurological disorders with symptoms such as chronic pain,depression,and insomnia are widespread.Very weak electric fields applied through the skull can enhance or diminish neural activity and modulate brain waves in ...Neurological disorders with symptoms such as chronic pain,depression,and insomnia are widespread.Very weak electric fields applied through the skull can enhance or diminish neural activity and modulate brain waves in order to treat many of these common medical problems.This approach is to be contrasted with well-established pharmacological methods or more recent invasive electrical Deep Brain Stimulation(DBS)techniques that require surgery to insert electrodes deep into the brain.We claim that Non-Invasive Brain Stimulation(NIBS)will provide new treatment methods with much greater simplicity,lower cost,improved safety and in some cases,possibly greater effectiveness.This emerging use of NIBS is a branch of a new multidisciplinary field that we coined Neuro-systems Engineering[1].This field involves neuroscientists,psychologists,and electrical engineers.This emerging field relies on existing standards for the safe implementation of these novel treatment modalities[2].Methods of stimulating the brain are based on emerging electro-technologies such as transcranial Direct Current/Alternating Current(DC/AC)electric fields and pulsed magnetic fields.Application of functional and time-dependent brain imaging methods can be used to locate relevant brain regions and determine the most appropriate stimulation method.Application of tailored and individualized control can be combined with other therapy methods to effectively treat neurological disorders while minimizing or even eliminating the use of pharmaceuticals.In this paper,we are presenting our embodiment for a closed loop,feedback controlled,non-invasive application of electrical stimulation of the brain to enhance individual/group performance or to treat neurological disorders.展开更多
Objective:We investigated changes in cortico–subcortical spatiotemporal dynamics to explore the treatment mechanisms oftranscranial alternating current stimulation(tACS)in patientswith Parkinson’s disease(PD).Method...Objective:We investigated changes in cortico–subcortical spatiotemporal dynamics to explore the treatment mechanisms oftranscranial alternating current stimulation(tACS)in patientswith Parkinson’s disease(PD).Methods:Resting-state functional magnetic resonance imaging(rs-fMRI)data were collected from 20 patients with PD and 20 normal controls(NC).Each patient with PD received successivemultidisciplinary intensive rehabilitation treatment and tACStreatment over a one-year interval.Individual functional brain network mapping and co-activation pattern(CAP)analysis were performed to characterize cortico–subcortical dynamics.Results:The same tACS electrode placement stimulated different proportions of functional brain networks across the participants.CAP analysis revealed that the visual network,attentional network,and default mode network co-activated with the thalamus,accumbens,and amygdala,respectively.The pattern characterized by thede-activation of the visual network and the activation of the thalamus showed a significantly low amplitude in the patients with PD than inNCs,and this amplitude increased after tACS treatment.Furthermore,the co-occurrence of cortico–subcortical CAPs was significantly higherin patients with PD than in NCs and decreased after tACS treatment.Conclusions:This study investigated cortico–subcortical spatiotemporaldynamics in patients with PD and further revealed the tACS treatmentmechanism.These findings contribute to understanding cortico–subcortical dynamics and exploring noninvasive neuromodulationtargets of cortico–subcortical circuits in brain diseases,such as PD,Alzheimer’s disease,and depression.展开更多
Non-invasive brain current stimulation（NIBS） is a promising and versatile tool for inducing neuroplasticity,protection and functional rehabilitation of damaged neuronal systems.It is technically simple,requires no s...Non-invasive brain current stimulation（NIBS） is a promising and versatile tool for inducing neuroplasticity,protection and functional rehabilitation of damaged neuronal systems.It is technically simple,requires no surgery,and has significant beneficial effects.However,there are various technical approaches for NIBS which influence neuronal networks in significantly different ways.Transcranial direct current stimulation（t DCS）,alternating current stimulation（ACS） and repetitive transcranial magnetic stimulation（r TMS） all have been applied to modulate brain activity in animal experiments under normal and pathological conditions.Also clinical trials have shown that t DCS,r TMS and ACS induce significant behavioural effects and can – depending on the parameters chosen – enhance or decrease brain excitability and influence performance and learning as well as rehabilitation and protective mechanisms.The diverse phaenomena and partially opposing effects of NIBS are not yet fully understood and mechanisms of action need to be explored further in order to select appropriate parameters for a given task,such as current type and strength,timing,distribution of current densities and electrode position.In this review,we will discuss the various parameters which need to be considered when designing a NIBS protocol and will put them into context with the envisaged applications in experimental neurobiology and medicine such as vision restoration,motor rehabilitation and cognitive enhancement.展开更多
双相障碍是一种常见的重性精神疾病,以抑郁和躁狂交替发作为主要表现,其病因复杂,发病机制仍未明确,给家庭和社会造成了极大的疾病负担。目前国内外指南仍以药物治疗为主,但其在降低疾病复发率和自杀率等方面的效果比较有限,因此,亟需...双相障碍是一种常见的重性精神疾病,以抑郁和躁狂交替发作为主要表现,其病因复杂,发病机制仍未明确,给家庭和社会造成了极大的疾病负担。目前国内外指南仍以药物治疗为主,但其在降低疾病复发率和自杀率等方面的效果比较有限,因此,亟需新的治疗手段来增效药物治疗。近年来,无创性神经调控技术发展迅速,本文将经颅直流电刺激(transcranial direct current stimulation,tDCS)、重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)、经颅交流电刺激(transcranial alternating current stimulation,tACS)、经颅聚焦超声(transcranial focused ultrasound stimulation,tFUS)在双相障碍治疗中的相关机制、效果、局限性和未来发展方向进行综述,为优化双相障碍的诊疗提供参考依据。展开更多
经颅交流电刺激(transcranial alternating current stimulation,tACS)是一种无创的神经调控技术,其在脑内产生的弱电场能够与内源性、节律性的神经网络活动协同作用,调节机体的精神活动。由于神经网络振荡能够调节机体的意识和认知功能...经颅交流电刺激(transcranial alternating current stimulation,tACS)是一种无创的神经调控技术,其在脑内产生的弱电场能够与内源性、节律性的神经网络活动协同作用,调节机体的精神活动。由于神经网络振荡能够调节机体的意识和认知功能,tACS用于临床治疗可以改善患者的多种精神症状。强迫症是一种高致残率、高复发率的难治性精神障碍疾病,它是全球主要的公共卫生问题之一。而tACS在强迫症治疗中的临床效果和涉及的神经机制还有待进一步探究。鉴于上述科学问题,本文主要归纳了tACS作用的潜在机制,并分别从疗效影响因素、tACS应用现状以及局限性和改进方法等方面,探讨了tACS在治疗强迫症中的临床应用前景。展开更多
抑郁症是以情绪低落为主要表现,伴有认知和行为改变的一种常见精神疾病。目前常用的抗抑郁药物起效缓慢、治疗周期长、复发率高,存在明显缺陷。经颅交流电刺激(transcranial alternating current stimulation,tACS)是一种非侵入性脑刺...抑郁症是以情绪低落为主要表现,伴有认知和行为改变的一种常见精神疾病。目前常用的抗抑郁药物起效缓慢、治疗周期长、复发率高,存在明显缺陷。经颅交流电刺激(transcranial alternating current stimulation,tACS)是一种非侵入性脑刺激技术,近年来逐渐应用于抑郁症的治疗中。抑郁症和大脑内源性神经振荡、突触可塑性的异常有关,tACS可以对以上机制产生影响,从而治疗抑郁症。不同频率的tACS刺激可以改善抑郁症状,其中以γ、α频率的刺激最受关注。本文主要对tACS的可能作用机制以及不同频率tACS在抑郁症中的应用进行综述,有助于进一步探讨tACS治疗抑郁症的可行性。展开更多
文摘For decades visual field defects were considered irreversible because it was thought that in the visual system the regeneration potential of the neuronal tissues is low.Nevertheless,there is always some potential for partial recovery of the visual field defect that can be achieved through induction of neuroplasticity.Neuroplasticity refers to the ability of the brain to change its own functional architecture by modulating synaptic efficacy.It is maintained throughout life and just as neurological rehabilitation can improve motor coordination,visual field defects in glaucoma,diabetic retinopathy or optic neuropathy can be improved by inducing neuroplasticity.In ophthalmology many new treatment paradigms have been tested that can induce neuroplastic changes,including non-invasive alternating current stimulation.Treatment with alternating current stimulation(e.g.,30 minutes,daily for 10 days using transorbital electrodes and^10 Hz)activates the entire retina and parts of the brain.Electroencephalography and functional magnetic resonance imaging studies revealed local activation of the visual cortex,global reorganization of functional brain networks,and enhanced blood flow,which together activate neurons and their networks.The future of low vision is optimistic because vision loss is indeed,partially reversible.
基金This work is supported by the National Key R&D Program of China(No.2017YFC1310001)the National Natural Science Foundation of China(No.81771862)+2 种基金the Beijing Municipal Science and Technology Project(No.Z171100000117016)the Beijing Natural Science Foundation(No.KZ201710025017)the Beijing Hundred,Thousand,and Ten Thousand Talents Project(No.2017-CXYF-09).
文摘Background:Transcranial alternating current stimulation(tACS)offers a new approach for adult patients with major depressive disorder(MDD).The study is to evaluate the efficacy and safety of tACS treating MDD.Methods:This is an 8-week,double-blind,randomized,placebo-controlled study.Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min,77.5-Hz,15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks(week 4),following a 4-week observation period(week 8).The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale(HDRS-17)score≤7 at week 8.Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17,the proportion of participants having improvement in the clinical global impression-improvement,the change in HDRS-17 score(range,0-52,with higher scores indicating more depression)over the study,and variations of brain imaging and neurocognition from baseline to week 4.Safety will be assessed by vital signs at weeks 4 and 8,and adverse events will be collected during the entire study.Discussion:The tACS applied in this trial may have treatment effects on MDD with minimal side effects.Trial registration:Chinese Clinical Trial Registry,ChiCTR1800016479;http://www.chictr.org.cn/showproj.aspx?proj=22048.
文摘Neurological disorders with symptoms such as chronic pain,depression,and insomnia are widespread.Very weak electric fields applied through the skull can enhance or diminish neural activity and modulate brain waves in order to treat many of these common medical problems.This approach is to be contrasted with well-established pharmacological methods or more recent invasive electrical Deep Brain Stimulation(DBS)techniques that require surgery to insert electrodes deep into the brain.We claim that Non-Invasive Brain Stimulation(NIBS)will provide new treatment methods with much greater simplicity,lower cost,improved safety and in some cases,possibly greater effectiveness.This emerging use of NIBS is a branch of a new multidisciplinary field that we coined Neuro-systems Engineering[1].This field involves neuroscientists,psychologists,and electrical engineers.This emerging field relies on existing standards for the safe implementation of these novel treatment modalities[2].Methods of stimulating the brain are based on emerging electro-technologies such as transcranial Direct Current/Alternating Current(DC/AC)electric fields and pulsed magnetic fields.Application of functional and time-dependent brain imaging methods can be used to locate relevant brain regions and determine the most appropriate stimulation method.Application of tailored and individualized control can be combined with other therapy methods to effectively treat neurological disorders while minimizing or even eliminating the use of pharmaceuticals.In this paper,we are presenting our embodiment for a closed loop,feedback controlled,non-invasive application of electrical stimulation of the brain to enhance individual/group performance or to treat neurological disorders.
基金This work was supported by the National Natural Science Foundation of China(Grant Nos.U20A20191,82071912,12104049,82202291)the Fundamental Research Funds for the Central Universities(Grant No.2021CX11011)the National Key Research and Development Program of China(Grant No.2020YFC2007305).
文摘Objective:We investigated changes in cortico–subcortical spatiotemporal dynamics to explore the treatment mechanisms oftranscranial alternating current stimulation(tACS)in patientswith Parkinson’s disease(PD).Methods:Resting-state functional magnetic resonance imaging(rs-fMRI)data were collected from 20 patients with PD and 20 normal controls(NC).Each patient with PD received successivemultidisciplinary intensive rehabilitation treatment and tACStreatment over a one-year interval.Individual functional brain network mapping and co-activation pattern(CAP)analysis were performed to characterize cortico–subcortical dynamics.Results:The same tACS electrode placement stimulated different proportions of functional brain networks across the participants.CAP analysis revealed that the visual network,attentional network,and default mode network co-activated with the thalamus,accumbens,and amygdala,respectively.The pattern characterized by thede-activation of the visual network and the activation of the thalamus showed a significantly low amplitude in the patients with PD than inNCs,and this amplitude increased after tACS treatment.Furthermore,the co-occurrence of cortico–subcortical CAPs was significantly higherin patients with PD than in NCs and decreased after tACS treatment.Conclusions:This study investigated cortico–subcortical spatiotemporaldynamics in patients with PD and further revealed the tACS treatmentmechanism.These findings contribute to understanding cortico–subcortical dynamics and exploring noninvasive neuromodulationtargets of cortico–subcortical circuits in brain diseases,such as PD,Alzheimer’s disease,and depression.
文摘Non-invasive brain current stimulation（NIBS） is a promising and versatile tool for inducing neuroplasticity,protection and functional rehabilitation of damaged neuronal systems.It is technically simple,requires no surgery,and has significant beneficial effects.However,there are various technical approaches for NIBS which influence neuronal networks in significantly different ways.Transcranial direct current stimulation（t DCS）,alternating current stimulation（ACS） and repetitive transcranial magnetic stimulation（r TMS） all have been applied to modulate brain activity in animal experiments under normal and pathological conditions.Also clinical trials have shown that t DCS,r TMS and ACS induce significant behavioural effects and can – depending on the parameters chosen – enhance or decrease brain excitability and influence performance and learning as well as rehabilitation and protective mechanisms.The diverse phaenomena and partially opposing effects of NIBS are not yet fully understood and mechanisms of action need to be explored further in order to select appropriate parameters for a given task,such as current type and strength,timing,distribution of current densities and electrode position.In this review,we will discuss the various parameters which need to be considered when designing a NIBS protocol and will put them into context with the envisaged applications in experimental neurobiology and medicine such as vision restoration,motor rehabilitation and cognitive enhancement.
文摘双相障碍是一种常见的重性精神疾病,以抑郁和躁狂交替发作为主要表现,其病因复杂,发病机制仍未明确,给家庭和社会造成了极大的疾病负担。目前国内外指南仍以药物治疗为主,但其在降低疾病复发率和自杀率等方面的效果比较有限,因此,亟需新的治疗手段来增效药物治疗。近年来,无创性神经调控技术发展迅速,本文将经颅直流电刺激(transcranial direct current stimulation,tDCS)、重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)、经颅交流电刺激(transcranial alternating current stimulation,tACS)、经颅聚焦超声(transcranial focused ultrasound stimulation,tFUS)在双相障碍治疗中的相关机制、效果、局限性和未来发展方向进行综述,为优化双相障碍的诊疗提供参考依据。
文摘经颅交流电刺激(transcranial alternating current stimulation,tACS)是一种无创的神经调控技术,其在脑内产生的弱电场能够与内源性、节律性的神经网络活动协同作用,调节机体的精神活动。由于神经网络振荡能够调节机体的意识和认知功能,tACS用于临床治疗可以改善患者的多种精神症状。强迫症是一种高致残率、高复发率的难治性精神障碍疾病,它是全球主要的公共卫生问题之一。而tACS在强迫症治疗中的临床效果和涉及的神经机制还有待进一步探究。鉴于上述科学问题,本文主要归纳了tACS作用的潜在机制,并分别从疗效影响因素、tACS应用现状以及局限性和改进方法等方面,探讨了tACS在治疗强迫症中的临床应用前景。
文摘抑郁症是以情绪低落为主要表现,伴有认知和行为改变的一种常见精神疾病。目前常用的抗抑郁药物起效缓慢、治疗周期长、复发率高,存在明显缺陷。经颅交流电刺激(transcranial alternating current stimulation,tACS)是一种非侵入性脑刺激技术,近年来逐渐应用于抑郁症的治疗中。抑郁症和大脑内源性神经振荡、突触可塑性的异常有关,tACS可以对以上机制产生影响,从而治疗抑郁症。不同频率的tACS刺激可以改善抑郁症状,其中以γ、α频率的刺激最受关注。本文主要对tACS的可能作用机制以及不同频率tACS在抑郁症中的应用进行综述,有助于进一步探讨tACS治疗抑郁症的可行性。
