背景:电活动对神经元的发育和存活具有至关重要的影响。最近的许多研究表明,非侵入性电刺激(NES)在各种视网膜疾病中具有神经保护作用。
目的:系统回顾体内研究文献,全面总结NES对视网膜疾病的神经保护作用和机制。
方法:根据PRISMA指南,在PubMed进行了系统审查,WebofScience,Embase,Scopus和Cochrane图书馆收集了直到2023年9月发表的关于“NES对视网膜疾病的作用”的所有相关体内研究。使用采用的SYRCLE工具确定了可能的偏见。
结果:在最初收集的791项研究中,21篇文章符合全文审查的纳入/排除标准。结果揭示了NES的神经保护作用(涉及全眼,经角膜,经巩膜,跨椎体,经眶电刺激)对不同的视网膜疾病,包括视网膜色素变性,视网膜变性,高眼压损伤,外伤性视神经病变,非动脉炎性缺血性视神经病变。NES能有效延缓视网膜神经元的变性和凋亡,保护视网膜结构和视觉功能,具有很高的安全性,其作用机制可能与促进神经营养因子和生长因子的分泌有关,减少炎症,抑制细胞凋亡。纳入研究的质量评分为5~8分(共10分),根据SYRCLE的偏见工具的风险。
结论:本系统综述表明,NES主要通过其神经营养作用对视网膜疾病模型发挥神经保护作用。抗炎,和抗凋亡能力。为了评估NES在治疗环境中的疗效,然而,未来需要精心设计的临床试验。
Electrical activity has a crucial impact on the development and survival of neurons. Numerous recent studies have shown that noninvasive electrical stimulation (NES) has neuroprotective action in various retinal disorders.
To systematically
review the literature on in vivo studies and provide a comprehensive summary of the neuroprotective action and the mechanisms of NES on retinal disorders.
Based on the PRISMA guideline, a systematic
review was conducted in PubMed, Web of Science, Embase, Scopus and Cochrane Library to collect all relevant in vivo studies on \"the role of NES on retinal diseases\" published up until September 2023. Possible biases were identified with the adopted SYRCLE\'s tool.
Of the 791 initially gathered studies, 21 articles met inclusion/exclusion criteria for full-text
review. The results revealed the neuroprotective effect of NES (involved whole-eye, transcorneal, transscleral, transpalpebral, transorbital electrical stimulation) on different retinal diseases, including retinitis pigmentosa, retinal degeneration, high-intraocular pressure injury, traumatic optic neuropathy, nonarteritic ischemic optic neuropathy. NES could effectively delay degeneration and apoptosis of retinal neurons, preserve retinal structure and visual function with high security, and its mechanism of action might be related to promoting the secretion of neurotrophins and growth factors, decreasing inflammation, inhibiting apoptosis. The quality scores of included studies ranged from 5 to 8 points (a total of 10 points), according to SYRCLE\'s risk of bias tool.
This systematic
review indicated that NES exerts neuroprotective effects on retinal disease models mainly through its neurotrophic, anti-inflammatory, and anti-apoptotic capabilities. To assess the efficacy of NES in a therapeutic setting, however, well-designed clinical trials are required in the future.