Objective Repetitive transcranial magnetic stimulation(rTMS)has demonstrated efficacy in enhancing neurocognitive performance in Alzheimer’s disease(AD),but the neurobiological mechanisms linking synaptic pathology,n...Objective Repetitive transcranial magnetic stimulation(rTMS)has demonstrated efficacy in enhancing neurocognitive performance in Alzheimer’s disease(AD),but the neurobiological mechanisms linking synaptic pathology,neural oscillatory dynamics,and brain network reorganization remain unclear.This investigation seeks to systematically evaluate the therapeutic potential of rTMS as a non-invasive neuromodulatory intervention through a multimodal framework integrating clinical assessments,molecular profiling,and neurophysiological monitoring.Methods In this prospective double-blind trial,12 AD patients underwent a 14-day protocol of 20 Hz rTMS,with comprehensive multimodal assessments performed pre-and postintervention.Cognitive functioning was quantified using the mini-mental state examination(MMSE)and Montreal cognitive assessment(MOCA),while daily living capacities and neuropsychiatric profiles were respectively evaluated through the activities of daily living(ADL)scale and combined neuropsychiatric inventory(NPI)-Hamilton depression rating scale(HAMD).Peripheral blood biomarkers,specifically Aβ1-40 and phosphorylated tau(p-tau181),were analyzed to investigate the effects of rTMS on molecular metabolism.Spectral power analysis was employed to investigate rTMS-induced modulations of neural rhythms in AD patients,while brain network analyses incorporating topological properties were conducted to examine stimulus-driven network reorganization.Furthermore,systematic assessment of correlations between cognitive scale scores,blood biomarkers,and network characteristics was performed to elucidate cross-modal therapeutic associations.Results Clinically,MMSE and MOCA scores improved significantly(P<0.05).Biomarker showed that Aβ1-40 level increased(P<0.05),contrasting with p-tau181 reduction.Moreover,the levels of Aβ1-40 were positively correlated with MMSE and MOCA scores.Post-intervention analyses revealed significant modulations in oscillatory power,characterized by pronounced reductions in delta(P<0.05)and theta bands(P<0.05),while concurrent enhancements were observed in alpha,beta,and gamma band activities(all P<0.05).Network analysis revealed frequency-specific reorganization:clustering coefficients were significantly decreased in delta,theta,and alpha bands(P<0.05),while global efficiency improvement was exclusively detected in the delta band(P<0.05).The alpha band demonstrated concurrent increases in average nodal degree(P<0.05)and characteristic path length reduction(P<0.05).Further research findings indicate that the changes in the clinical scale HAMD scores before and after rTMS stimulation are negatively correlated with the changes in the blood biomarkers Aβ1-40 and p-tau181.Additionally,the changes in the clinical scales MMSE and MoCA scores were negatively correlated with the changes in the node degree of the alpha frequency band and negatively correlated with the clustering coefficient of the delta frequency band.However,the changes in MMSE scores are positively correlated with the changes in global efficiency of both the delta and alpha frequency bands.Conclusion 20 Hz rTMS targeting dorsolateral prefrontal cortex(DLPFC)significantly improves cognitive function and enhances the metabolic clearance ofβ-amyloid and tau proteins in AD patients.This neurotherapeutic effect is mechanistically associated with rTMS-mediated frequency-selective neuromodulation,which enhances the connectivity of oscillatory networks through improved neuronal synchronization and optimized topological organization of functional brain networks.These findings not only support the efficacy of rTMS as an adjunctive therapy for AD but also underscore the importance of employing multiple assessment methods—including clinical scales,blood biomarkers,and EEG——in understanding and monitoring the progression of AD.This research provides a significant theoretical foundation and empirical evidence for further exploration of rTMS applications in AD treatment.展开更多
Brain functional networks model the brain's ability to exchange information across different regions,aiding in the understanding of the cognitive process of human visual attention during target searching,thereby c...Brain functional networks model the brain's ability to exchange information across different regions,aiding in the understanding of the cognitive process of human visual attention during target searching,thereby contributing to the advancement of camouflage evaluation.In this study,images with various camouflage effects were presented to observers to generate electroencephalography(EEG)signals,which were then used to construct a brain functional network.The topological parameters of the network were subsequently extracted and input into a machine learning model for training.The results indicate that most of the classifiers achieved accuracy rates exceeding 70%.Specifically,the Logistic algorithm achieved an accuracy of 81.67%.Therefore,it is possible to predict target camouflage effectiveness with high accuracy without the need to calculate discovery probability.The proposed method fully considers the aspects of human visual and cognitive processes,overcomes the subjectivity of human interpretation,and achieves stable and reliable accuracy.展开更多
目的探讨抑郁障碍和双相障碍患者脑白质网络节点强度的差异,分析患者不同脑区的结构连接受损情况及其在鉴别中的作用。方法纳入91例基线诊断为抑郁发作的患者,经过≥9年的自然观察随访后,最终确定23例维持抑郁障碍诊断(单相组)和18例维...目的探讨抑郁障碍和双相障碍患者脑白质网络节点强度的差异,分析患者不同脑区的结构连接受损情况及其在鉴别中的作用。方法纳入91例基线诊断为抑郁发作的患者,经过≥9年的自然观察随访后,最终确定23例维持抑郁障碍诊断(单相组)和18例维持双相障碍诊断(双相组)的患者纳入分析。同时纳入30名健康对照者(对照组)。受试者在入组时均接受弥散张量成像扫描,采用确定性纤维追踪技术构建脑白质结构加权网络。比较三组间脑白质网络的节点连接强度差异,进一步采用受试者操作特征(receiver operator characteristic,ROC)曲线评估差异脑区对抑郁障碍和双相障碍鉴别诊断的价值。结果双相组在左前扣带回的节点强度较单相组降低(3.89±0.76 vs.4.74±0.60),在右尾状核(4.94±1.26 vs.3.46±0.99)、右苍白球(1.98±0.67 vs.1.25±0.29)的节点强度较单相组升高(P<0.01,FWE校正)。左前扣带回、右尾状核、右苍白球3个脑区的连接强度联合鉴别抑郁障碍和双相障碍绘制ROC曲线,曲线下面积(area under the curve,AUC)为0.95(95%CI:0.91~0.99;P<0.01),敏感度0.89,特异度0.87。结论脑结构网络的节点强度差异可以作为一个潜在的影像学生物标志物识别抑郁障碍和双相障碍,联合差异脑区的节点强度可以得到更好的识别率。展开更多
脑卒中是全球主要的致残原因之一,可导致患者在运动、感觉及认知功能上出现障碍。传统的康复治疗周期长、见效慢,而近年来脑机接口、健侧第七颈神经移位术、脑刺激和细胞治疗等技术在卒中患者群体中的应用旨在增强脑可塑性、缓解症状,...脑卒中是全球主要的致残原因之一,可导致患者在运动、感觉及认知功能上出现障碍。传统的康复治疗周期长、见效慢,而近年来脑机接口、健侧第七颈神经移位术、脑刺激和细胞治疗等技术在卒中患者群体中的应用旨在增强脑可塑性、缓解症状,为临床提供了新的治疗思路。功能磁共振成像(functional magnetic resonance imaging,fMRI)作为脑科学重要的研究工具之一,已经广泛应用于脑卒中康复的研究中,它不仅能描述功能和网络连接变化,还能预测康复预后、指导治疗方案和监测康复效果,为脑卒中康复治疗提供了理论依据。本综述总结了近年来国内外应用fMRI技术在脑卒中康复期脑网络重塑等方面的探索,分析了相关研究成果以及存在的难点,以期为脑卒中康复治疗的fMRI研究提供新的思路。展开更多
文摘Objective Repetitive transcranial magnetic stimulation(rTMS)has demonstrated efficacy in enhancing neurocognitive performance in Alzheimer’s disease(AD),but the neurobiological mechanisms linking synaptic pathology,neural oscillatory dynamics,and brain network reorganization remain unclear.This investigation seeks to systematically evaluate the therapeutic potential of rTMS as a non-invasive neuromodulatory intervention through a multimodal framework integrating clinical assessments,molecular profiling,and neurophysiological monitoring.Methods In this prospective double-blind trial,12 AD patients underwent a 14-day protocol of 20 Hz rTMS,with comprehensive multimodal assessments performed pre-and postintervention.Cognitive functioning was quantified using the mini-mental state examination(MMSE)and Montreal cognitive assessment(MOCA),while daily living capacities and neuropsychiatric profiles were respectively evaluated through the activities of daily living(ADL)scale and combined neuropsychiatric inventory(NPI)-Hamilton depression rating scale(HAMD).Peripheral blood biomarkers,specifically Aβ1-40 and phosphorylated tau(p-tau181),were analyzed to investigate the effects of rTMS on molecular metabolism.Spectral power analysis was employed to investigate rTMS-induced modulations of neural rhythms in AD patients,while brain network analyses incorporating topological properties were conducted to examine stimulus-driven network reorganization.Furthermore,systematic assessment of correlations between cognitive scale scores,blood biomarkers,and network characteristics was performed to elucidate cross-modal therapeutic associations.Results Clinically,MMSE and MOCA scores improved significantly(P<0.05).Biomarker showed that Aβ1-40 level increased(P<0.05),contrasting with p-tau181 reduction.Moreover,the levels of Aβ1-40 were positively correlated with MMSE and MOCA scores.Post-intervention analyses revealed significant modulations in oscillatory power,characterized by pronounced reductions in delta(P<0.05)and theta bands(P<0.05),while concurrent enhancements were observed in alpha,beta,and gamma band activities(all P<0.05).Network analysis revealed frequency-specific reorganization:clustering coefficients were significantly decreased in delta,theta,and alpha bands(P<0.05),while global efficiency improvement was exclusively detected in the delta band(P<0.05).The alpha band demonstrated concurrent increases in average nodal degree(P<0.05)and characteristic path length reduction(P<0.05).Further research findings indicate that the changes in the clinical scale HAMD scores before and after rTMS stimulation are negatively correlated with the changes in the blood biomarkers Aβ1-40 and p-tau181.Additionally,the changes in the clinical scales MMSE and MoCA scores were negatively correlated with the changes in the node degree of the alpha frequency band and negatively correlated with the clustering coefficient of the delta frequency band.However,the changes in MMSE scores are positively correlated with the changes in global efficiency of both the delta and alpha frequency bands.Conclusion 20 Hz rTMS targeting dorsolateral prefrontal cortex(DLPFC)significantly improves cognitive function and enhances the metabolic clearance ofβ-amyloid and tau proteins in AD patients.This neurotherapeutic effect is mechanistically associated with rTMS-mediated frequency-selective neuromodulation,which enhances the connectivity of oscillatory networks through improved neuronal synchronization and optimized topological organization of functional brain networks.These findings not only support the efficacy of rTMS as an adjunctive therapy for AD but also underscore the importance of employing multiple assessment methods—including clinical scales,blood biomarkers,and EEG——in understanding and monitoring the progression of AD.This research provides a significant theoretical foundation and empirical evidence for further exploration of rTMS applications in AD treatment.
基金sponsored by the National Defense Science and Technology Key Laboratory Fund(Grant No.61422062205)the Equipment Pre-Research Fund(Grant No.JCKYS2022LD9)。
文摘Brain functional networks model the brain's ability to exchange information across different regions,aiding in the understanding of the cognitive process of human visual attention during target searching,thereby contributing to the advancement of camouflage evaluation.In this study,images with various camouflage effects were presented to observers to generate electroencephalography(EEG)signals,which were then used to construct a brain functional network.The topological parameters of the network were subsequently extracted and input into a machine learning model for training.The results indicate that most of the classifiers achieved accuracy rates exceeding 70%.Specifically,the Logistic algorithm achieved an accuracy of 81.67%.Therefore,it is possible to predict target camouflage effectiveness with high accuracy without the need to calculate discovery probability.The proposed method fully considers the aspects of human visual and cognitive processes,overcomes the subjectivity of human interpretation,and achieves stable and reliable accuracy.
文摘目的探讨抑郁障碍和双相障碍患者脑白质网络节点强度的差异,分析患者不同脑区的结构连接受损情况及其在鉴别中的作用。方法纳入91例基线诊断为抑郁发作的患者,经过≥9年的自然观察随访后,最终确定23例维持抑郁障碍诊断(单相组)和18例维持双相障碍诊断(双相组)的患者纳入分析。同时纳入30名健康对照者(对照组)。受试者在入组时均接受弥散张量成像扫描,采用确定性纤维追踪技术构建脑白质结构加权网络。比较三组间脑白质网络的节点连接强度差异,进一步采用受试者操作特征(receiver operator characteristic,ROC)曲线评估差异脑区对抑郁障碍和双相障碍鉴别诊断的价值。结果双相组在左前扣带回的节点强度较单相组降低(3.89±0.76 vs.4.74±0.60),在右尾状核(4.94±1.26 vs.3.46±0.99)、右苍白球(1.98±0.67 vs.1.25±0.29)的节点强度较单相组升高(P<0.01,FWE校正)。左前扣带回、右尾状核、右苍白球3个脑区的连接强度联合鉴别抑郁障碍和双相障碍绘制ROC曲线,曲线下面积(area under the curve,AUC)为0.95(95%CI:0.91~0.99;P<0.01),敏感度0.89,特异度0.87。结论脑结构网络的节点强度差异可以作为一个潜在的影像学生物标志物识别抑郁障碍和双相障碍,联合差异脑区的节点强度可以得到更好的识别率。
文摘脑卒中是全球主要的致残原因之一,可导致患者在运动、感觉及认知功能上出现障碍。传统的康复治疗周期长、见效慢,而近年来脑机接口、健侧第七颈神经移位术、脑刺激和细胞治疗等技术在卒中患者群体中的应用旨在增强脑可塑性、缓解症状,为临床提供了新的治疗思路。功能磁共振成像(functional magnetic resonance imaging,fMRI)作为脑科学重要的研究工具之一,已经广泛应用于脑卒中康复的研究中,它不仅能描述功能和网络连接变化,还能预测康复预后、指导治疗方案和监测康复效果,为脑卒中康复治疗提供了理论依据。本综述总结了近年来国内外应用fMRI技术在脑卒中康复期脑网络重塑等方面的探索,分析了相关研究成果以及存在的难点,以期为脑卒中康复治疗的fMRI研究提供新的思路。
