其他非侵入性脑刺激技术无法比拟的,经颅超声(TUS)不仅在皮质表面而且在脑深部结构中提供高度聚焦刺激。这些独特的属性在基础和临床研究中都是无价的,并可能为治疗神经和精神疾病开辟新的途径。这里,我们简要概述了近年来不断扩大的临床研究数量以及即将开展的有关聚焦超声神经调节的研究计划.目前,临床TUS研究涉及各种神经精神疾病,如疼痛,痴呆症,运动障碍,精神病,癫痫,意识障碍,和发育障碍。正如在假对照随机研究中所证明的那样,TUS神经调节改善认知功能和情绪,缓解了精神分裂症和自闭症的症状。Further,不受控制的初步证据表明焦虑得到缓解,运动障碍的运动功能增强,减少癫痫发作频率,改善最低意识状态患者的反应性,以及神经调节TUS后疼痛减轻。虽然受到调查数量相对较少的限制,主要由小样本量的不受控制的可行性试验组成,TUS在治疗神经精神疾病方面具有令人鼓舞的前景。较大的假对照随机对照试验,除了对作用机制和最佳超声处理参数进行进一步的基础研究,不可避免地需要发挥TUS神经调节的全部潜力。
Unmatched by other non-invasive brain stimulation techniques, transcranial ultrasound (TUS) offers highly focal stimulation not only on the cortical surface but also in deep brain structures. These unique attributes are invaluable in both basic and clinical research and might open new avenues for treating neurological and psychiatric diseases. Here, we provide a concise overview of the expanding volume of clinical investigations in recent years and upcoming research initiatives concerning focused ultrasound
neuromodulation. Currently, clinical TUS research addresses a variety of neuropsychiatric conditions, such as pain, dementia, movement disorders, psychiatric conditions, epilepsy, disorders of consciousness, and developmental disorders. As demonstrated in sham-controlled randomized studies, TUS
neuromodulation improved cognitive functions and mood, and alleviated symptoms in schizophrenia and autism. Further, preliminary uncontrolled evidence suggests relieved anxiety, enhanced motor functions in movement disorders, reduced epileptic seizure frequency, improved responsiveness in patients with minimally conscious state, as well as pain reduction after neuromodulatory TUS. While constrained by the relatively modest number of investigations, primarily consisting of uncontrolled feasibility trials with small sample sizes, TUS holds encouraging prospects for treating neuropsychiatric disorders. Larger sham-controlled randomized trials, alongside further basic research into the mechanisms of action and optimal sonication parameters, are inevitably needed to unfold the full potential of TUS
neuromodulation.