无创神经脑刺激在儿童心理障碍治疗中的应用

无创神经脑刺激治疗儿童心理障碍是当下较为先进的物理治疗手段。本文着重介绍了无创神经脑刺激的两种代表技术-经颅磁刺激与经颅直流电刺激的工作原理,两者分别在儿童抑郁症、注意缺陷多动障碍与孤独症谱系障碍中的治疗应用,以及对无创神经脑刺激在儿童心理障碍治疗中存在的问题与未来的发展,其中人工智能的引用是其发展很具潜力的方向。     

经颅直流电刺激的研究进展

经颅直流电刺激(transcrarfial direct current stimulation,tDCS)是一种非侵入性调节大脑皮层兴奋性的方法,在国外,系统研究tDCS始于20世纪60年代,随着最近对中枢神经系统的功能和病理的了解增加,tDCS在最近几年再度成为研究热点.     

经颅磁刺激技术的基本原理及应用现状

经颅磁刺激（TMS）技术是一种通过放置在头部表面的通电线圈来刺激人脑的技术,可通过调制大脑皮层神经元的膜电位来影响和改变大脑功能。TMS是一种无痛、无创的治疗办法,可有效应用于心理疾病、精神疾病以及神经疾病的诊断与治疗,目前已存精神心理学及康复医学领域得到了广泛应用。本文简述了TMS的熬本原理,并对其临床应用的现状和前景进行了归纳和总结。     

经颅磁刺激在神经发育障碍性疾病中的应用进展

神经发育障碍是一大类发病于幼年时期,以功能发育损害或延迟为主要特征的精神障碍。经颅磁刺激(TMS)技术作为一种无创的物理检查及治疗手段,既往在精神科及康复医学科已广泛使用,且有良好效果,目前已推广至神经发育障碍儿童中,本文着重介绍此项技术在儿童神经发育障碍疾病中的使用。     

重复经颅磁刺激对卒中后运动功能康复的临床观察

目的:探究重复经颅磁刺激对卒中后运动功能康复的效果。方法:选择我院2016年5月-2016年7月期间收治的48名脑梗死患者,分为实验组(r TMS)与对照组,对照组给予常规康复治疗法,实验组行重复经颅磁刺激(r TMS)康复训练,对比两组5周康复训练后FMA评分情况。结果:治疗前两组FMA评分对比差异无统计学意义,P0.05,治疗后实验组评分高于对照组,差异具有统计学意义,P0.05。结论:应用重复经颅磁刺激开展脑卒患者的康复治疗,有利于将患者肢体运动功能提高,改善病情,效果显著,值得临床实践应用。     

重复经颅磁刺激(rTMS)治疗抑郁症患者认知功能障碍的研究进展

目的:重复经颅磁刺激(rTMS)是一种安全、无创的新型治疗技术,在精神科领域中的使用日趋广泛,对抑郁症患者的疗效得到认可,然而,目前r TMS对抑郁症患者认知功能障碍是否具有增效作用尚不清楚。今对其最新研究进展做一综述。     

重复经颅磁刺激治疗抑郁症的神经机制探索及疗效预测研究进展

介绍了抑郁症的患病机制和临床治疗措施,重点从神经机制和疗效预测方面分析了近年来重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗抑郁症的研究进展,分析了rTMS主要是通过改善大脑网络异常连接来治疗抑郁症,同时发现了亚属扣带回(subgenual cingulate gyrus,SCG)皮层的基线连接对rTMS疗效预测具有重要作用。总结了rTMS抗抑郁治疗研究中存在的不足,指出了未来应着重于在多模式影像预测因子选择、rTMS参数设置和脑部刺激靶点选取等方面进行深入研究,为探索rTMS的抗抑郁机制和改善治疗效果提供了新的思路。     

经颅磁刺激系统的设计及其实现

经颅磁刺激是一种非侵入性的诊断和治疗技术.阐述了经颅磁刺激系统的设计和制作,其各项技术参数均能达到TMS实验研究的要求.     

经颅磁刺激技术在神经康复领域的应用

经颅磁刺激技术（TMS）诞生于上世纪80年代，是一种非侵入性的生物刺激技术。TMS能影响神经系统功能。与传统的电刺激技术相比，TMS有许多优势。这使得TMS成为神经功能研究领域一个非常重要的工具。随着TMS技术的发展，其在临床医学中的应用越来越受到重视。本综述将介绍TMS技术在神经康复领域的应用。     

经颅磁刺激仪的维护与检修探讨

经颅磁刺激仪在临床上被广泛应用于脑瘫、抑郁症、癫痫病、偏头痛、老年痴呆及精神分裂症等疾病的诊断中,该检测方式具有无损、无痛以及无创等特点,疾病诊断准确率较高,在广大患者中有着较高的接受度。当前,经颅磁刺激技术在国内诸多医院中获得了日益广泛的应用,但是关于经颅磁刺激治疗仪器的维修资料较少。本文就经颅磁刺激治疗仪器工作原理以及故障检修、日常维护等进行总结和探讨以供同行进行参考,现综述如下。     

Repetitive transcranial magnetic stimulation in depression; stimulation of the brain in order to cure the psyche

Transcranial magnetic stimulation (TMS) is a non-invasive approach to briefly stimulate or inhibit cortical brain areas. A novel approach entails the delivery of repetitive TMS pulses (rTMS) at a fixed frequency. In rTMS cortical activity is altered beyond the period of actual stimulation. The changes occur locally as well as at a distance in functionally connected brain areas. These features render rTMS a suitable tool to study normal brain functions and the pathophysiology of brain diseases. Furthermore, it is expected that rTMS could be used as a novel therapy for neurological or psychiatric diseases characterised by abnormal cortical activation. This possibility has been studied mostly in patients suffering from depression, where rTMS has been used to restore normal activity in the hypoactive prefrontal cortex. Despite statistically significant therapeutic effects in small sized trials, the clinical implications are still limited.     

The biological effects of magnetic stimulation in epileptic patients

BACKGROUND: The magnetoencephalogram (MEG) is the magnetic activity emitted by the brain, which can be measured using a superconductive quantum interference device (SQUID). This is a totally non-invasive method for localizing functional healthy, epileptic and other CNS brain disorders. METHODS: Using the MEG brain activity recorded from epileptic patients we were able to obtain a mapping technique characterized by the ISO-spectral amplitude of scalp distribution of the MEG Fourier power spectrum. In addition, by utilizing the above recorded MEG activity we energize an electronic device, which emits back to the abnormal brain points of the epileptic patients magnetic fields with proper frequencies and intensities. RESULTS: Using this method we present here in more detail three randomly selected epileptic patients in which application of external magnetic fields of low intensities and frequencies produced a substantial attenuation of their abnormal brain activity. Furthermore, we present a statistical analysis of 50 randomly selected epileptic patients who underwent magnetic stimulation for the treatment of their seizures and we found that the anticonvulsant response to magnetic stimulation was statistically significant (chi 2 = 6.55, df = 1, p < 0.02). CONCLUSIONS: Our findings indicate that the use of low external magnetic fields produce substantial attenuation in seizure activity in epileptic patients and therefore it may open new ways in the future for management of epileptic activity.     

Good taste or gut feeling? A new method in rats shows oro-sensory stimulation and gastric distention generate distinct and overlapping brain activation patterns

Satiation is influenced by a variety of signals including gastric distention and oro-sensory stimulation. Here we developed a high-field (9.4 T) functional magnetic resonance imaging (fMRI) protocol to test how oro-sensory stimulation and gastric distention, as induced with a block-design paradigm, affect brain activation under different states of energy balance in rats. Repeated tasting of sucrose induced positive and negative fMRI responses in the ventral tegmental area and septum, respectively, and gradual neural activation in the anterior insula and the brain stem nucleus of the solitary tract (NTS), as revealed using a two-level generalized linear model-based analysis. These unique findings align with comparable human experiments, and are now for the first time identified in rats, thereby allowing for comparison between species. Gastric distention induced more extensive brain activation, involving the insular cortex and NTS. Our findings are largely in line with human studies that have shown that the NTS is involved in processing both visceral information and taste, and anterior insula in processing sweet taste oro-sensory signals. Gastric distention and sucrose tasting induced responses in mesolimbic areas, to our knowledge not previously detected in humans, which may reflect the rewarding effects of a full stomach and sweet taste, thereby giving more insight into the processing of sensory signals leading to satiation. The similarities of these data to human neuroimaging data demonstrate the translational value of the approach and offer a new avenue to deepen our understanding of the process of satiation in healthy people and those with eating disorders.     

孤独谱系障碍患者大尺度脑网络功能连接改变的研究进展

静息态功能磁共振成像作为非侵入性且可视化成像方法,数据采集简便易行,已成为探索孤独谱系障碍(ASD)患者脑功能变化的主要成像手段。目前认为大尺度脑网络的模式提供了一种新的方式,可以进一步了解包括ASD在内的神经精神疾病的脑网络异常。本文对ASD患者核心脑网络功能连接的变化及其与症状的关系进行综述。     

磁刺激技术的研究现状及其在医学上的应用

磁刺激大脑皮层技术是80年代中期发展起来的用于中枢神经系统传导功能及传导障碍检测的新方法，与传统的电刺激相比，具有安全、有效、无痛、无损伤、易于重复及操作简单等优点，使得磁刺激技术成为神经电生理技术领域日益活跃的研究方向。本文介绍了磁刺激技术的研究现状、发展方向及其在临床诊断有治疗方面较有价值的应用。     

Deep brain stimulation as a therapeutic option for obesity: A critical review

Despite a better understanding of obesity pathophysiology, treating this disease remains a challenge. New therapeutic options are needed. Targeting the brain is a promising way, considering both the brain abnormalities in obesity and the effects of bariatric surgery on the gut-brain axis. Deep brain stimulation could be an alternative treatment for obesity since this safe and reversible neurosurgical procedure modulates neural circuits for therapeutic purposes. We aimed to provide a critical review of published clinical and preclinical studies in this field. Owing to the physiology of eating and brain alterations in people with obesity, two brain areas, namely the hypothalamus and the nucleus accumbens are putative targets. Preclinical studies with animal models of obesity showed that deep brain stimulation of hypothalamus or nucleus accumbens induces weight loss. The mechanisms of action remain to be fully elucidated. Preclinical data suggest that stimulation of nucleus accumbens reduces food intake, while stimulation of hypothalamus could increase resting energy expenditure. Clinical experience with deep brain stimulation for obesity remains limited to six patients with mixed results, but some clinical trials are ongoing. Thus, drawing clear conclusions about the effectiveness of this treatment is not yet possible, even if the results of preclinical studies are encouraging. Future clinical studies should examine its efficacy and safety, while preclinical studies could help understand its mechanisms of action. We hope that our review will provide ways to design further studies.     

Docosahexaenoic acid in neural signaling systems

Docosahexaenoic acid has been conserved in neural signalling systems in the cephalopods, fish, amphibian, reptiles, birds, mammals, primates and humans. This extreme conservation, despite wide genomic changes over 500 million years, testifies to a uniqueness of this molecule in the brain. The brain selectively incorporates docosahexaenoic acid and its rate of incorporation into the developing brain has been shown to be greater than ten times more efficient than its synthesis from the omega 3 fatty acids of land plant origin. Data has now been published demonstrating a significant influence of dietary omega 3 fatty acids on neural gene expression. As docosahexaenoic acid is the only omega 3 fatty acid in the brain, it is likely that it is the ligand involved. The selective uptake, requirement for function and stimulation of gene expression would have conferred an advantage to a primate which separated from the chimpanzees in the forests and woodlands and sought a different ecological niche. In view of the paucity of docosahexaenoic acid in the land food chain it is likely that the advantage would have been gained from a lacustrine or marine coastal habitat with access to food rich in docosahexaenoic acid and the accessory micronutrients, such as iodine, zinc, copper, manganese and selenium, of importance in brain development and protection against peroxidation. Land agricultural development has, in recent time, come to dominate the human food chain. The decline in use and availability of aquatic resources is not considered important by Langdon (2006) as he considers the resource was not needed for human evolution and can be replaced from the terrestrial food chain. This notion is not supported by the biochemistry nor the molecular biology. He misses the point that the shoreline hypothesis is not just dependent on docosahexaenoic acid but also on the other accessory nutrients specifically required by the brain. Moreover he neglects the basic principle of Darwinian evolution. The well documented greater efficiency of preformed docosahexaenoic acid for brain incorporation during development would have conferred a distinct survival advantage over those without it. All terrestrial mammals lost brain capacity in relation to advancing increase in body size. The rise in mental ill health and brain disorders, to replace all other costs in the European list of burdens of ill health, (Andlin Sobocki et al., 2005) raises interesting questions as to its association with the reduced availability and consumption of marine and fresh water products. The threat posed by the continued rise in brain disorders also raises questions of importance to present and future food and agricultural policies.     

SSRI-Related Modulation of Sexual Functioning is Predicted by Pre-treatment Resting State Functional Connectivity in Healthy Men

Sexual dysfunction related to treatment with selective serotonin reuptake inhibitors (SSRIs) is a common reason for discontinuation of otherwise effective antidepressant treatment regimens. Thus, identification of subjects at risk for this side effect remains a crucial challenge. After demonstrating task-related neural correlates of impaired sexual functioning under treatment with the SSRI paroxetine (Abler et al., 2011), we studied (1) if resting state brain function before treatment predicts subsequent development of treatment-related modulation of sexual function, and (2) which neural circuits relate to different aspects of the impairment. Effects of paroxetine and bupropion administration over 1 week on subjective sexual functioning were investigated in 17 healthy male volunteers in a placebo-controlled, randomized cross-over design using the Massachusetts General Hospital Sexual Function Questionnaire. Data from a 10 min eyes-closed resting state scan were used to analyze functional connectivity under placebo in previously identified brain regions, focussing on the sublenticular extended amygdala (SLEA), dopaminergic midbrain, and anterior cingulate cortex. Resting state functional connectivities of the pregenual anterior cingulate cortex (pgACC), midbrain, and insula to the SLEA sufficiently predicted the development of subjective SSRI-related decreased sexual functioning and distinguished vulnerable from resilient subjects. Furthermore, connectivity with the midbrain particularly predicted orgasm-related deficits, while connectivity with pgACC predicted sexual satisfaction. Linking SSRI-related subjective sexual functioning to pre-treatment resting state connectivities in cortico-subcortical network of sexual processing, we demonstrated the potential of novel, non-invasive and passive brain imaging techniques to guide therapeutic decisions and adjust treatment protocols in psychiatric disorders and sexual medicine.