1.昆明理工大学医学院,昆明 650500;2.缩略表:三转基因小鼠模型(triple transgenic,3×Tg);3.昆明理工大学
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国家自然科学基金(82360271,81760258),云南省“万人计划”青年拔尖人才专项(YNWR-QNBJ-2018-056,YNWR-QNBJ-2018-027)和云南省应激与神经系统损伤创新团队(202305AS350011)资助。
Medical School, Kunming University of Science and Technology, Kunming 650500, China
This work was supported by grants from The National Natural Science Foundation of China (82360271, 81760258), The Yunnan Ten Thousand Talents Plan Young and Elite Talents Project (YNWR-QNBJ-2018-056, YNWR-QNBJ-2018-027), and The Innovation Team of Stress and Disorder in Nervous System in Yunnan Province (202305AS350011).
阿尔茨海默病 (Alzheimer’s disease, AD) 是常见且严重的痴呆症之一, 严重危害患者的身心健康和生活质量, 同时给社会带来沉重的负担。近年来,经颅电刺激(transcranial electrical stimulation,tES)在改善AD认知功能方面表现出巨大的潜力,主要包括经颅直流电刺激(transcranial direct current stimulation,tDCS)和经颅交流电刺激(transcranial alternating current stimulation,tACS)两种类型。本文综述了tDCS和tACS改善AD的神经分子机制,其共性主要体现在发挥神经保护作用、通过增加脑血流量来改善神经血管障碍、影响神经胶质细胞的状态和功能、减少Aβ和p-tau蛋白、影响神经可塑性。值得注意的是,tDCS在优化神经血管单元、改善血脑屏障(blood brain barrier,BBB)方面展现出独特的积极影响。此外,在非AD啮齿类动物的研究中,tES在神经保护、神经胶质细胞、神经可塑性方面还表现出在AD研究中尚未探讨的、更为具体的神经分子机制。这些发现为深入理解tES的作用原理、AD的病理机制,以及探索治疗其他具有相似病理特征疾病的新途径提供了理论基础。
Alzheimer’s disease (AD) is one of the most common and severe dementias, severely affecting the physical and mental health and quality of life of patients and imposing a heavy burden on society. Recently, transcranial electrical stimulation (tES) has shown great potential for improving cognitive function in AD. Transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) are the two main forms of tES. The present review mainly summarizes the neuromolecular mechanisms of tDCS and tACS for the improvement of AD. Both techniques show similarities in exerting neuroprotective effects, improving cerebral blood flow to alleviate cerebrovascular dysfunction, affecting the state and function of astrocytes, affecting the levels of amyloid β-protein (Aβ) and phosphorylated tau (p-tau) proteins, and affecting neuroplasticity. Specifically, tDCS improves neuronal status, inhibits neuronal apoptosis, improves cholinergic neurons and reduces oxidative stress, etc., and further exerts neuroprotective effects, but tACS mainly maintains the normal function of cholinergic neurons to exert the effects. For the alleviation of cerebrovascular dysfunction, tDCS has particular advantages in optimizing the neural vascular unit and improving the blood-brain barrier. For astrocytes, tDCS attenuates inflammatory responses by inhibiting their activation. In contrast, the effect of tACS on the activation state of microglial cells is still controversial for enhancement in AD mice and inhibition in patients. For Aβ levels, the effects of tDCS in AD patients are also inconclusive, but in AD rodents, tDCS may regulate molecular pathways related to Aβ production and degradation, thereby removing Aβ. In addition, tACS reduces p-tau levels in AD patients, but tDCS shows a trend toward reduction. In short, the effect of tES on Aβ and p-tau needs further investigation. Regarding neuroplasticity, tDCS improves cortical and synaptic plasticity, but tACS improves only synaptic plasticity. However, both techniques do not affect the molecular level associated with plasticity. On the other hand, this review has summarized some interesting findings of tES in non-AD rodents that may be relevant to the pathological mechanisms of AD. For neuroprotection, tDCS can promote neurogenesis, GABAergic and glutamatergic neurotransmission, modulate neuroprotection-related signaling pathways, reduce oxidative stress, and protect hippocampal neurons. In addition, tDCS inhibits conversion of microglia to the M1 phenotype and promotes conversion to the M2 phenotype, thereby reducing neuroinflammation. Importantly, tDCS induces changes in molecular indices associated with synaptic plasticity. These findings in non-AD rodents provide a reference for understanding the potential effect and possible mechanism of tES in AD and for exploring new approaches to treat other diseases with similar pathological features. In addition, tES has shown some effects in AD rodents, such as tACS improving plasticity, that have not been studied in non-AD rodents. These effects suggest the particular complexity of the pathological mechanisms of AD, which should be considered when applying the results of tES studies in non-AD rodents to AD rodents. In conclusion, this review provides a comprehensive overview of the neuromolecular mechanisms of tES in AD research and highlights its promise as a non-invasive brain stimulation technique in the treatment of AD. Furthermore, tES will play an indispensable role in the treatment of neuropsychiatric disorders and in the study of brain function.
袁湲,陈壮飞,付玉.经颅电刺激改善阿尔茨海默病的神经分子机制[J].生物化学与生物物理进展,2025,52(5):1179-1195
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