Cortical stimulation for treatment of neurological disorders of hyperexcitability: a role of homeostatic plasticity  被引量:2

Cortical stimulation for treatment of neurological disorders of hyperexcitability: a role of homeostatic plasticity

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作  者:Zhi Chai Cungen Ma Xiaoming Jin 

机构地区:[1]Basic Medical College, Shanxi Key Laboratory of Innovative Drugs for Serious Illness Based on Inflammatory Reactions, Neurobiology Research Center, Shanxi University of Chinese Medicine [2]Institute of Brain Science, Shanxi Datong University [3]Department of Anatomy and Cell Biology, Department of Neurological Surgery, Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Indiana University School of Medicine

出  处:《Neural Regeneration Research》2019年第1期34-38,共5页中国神经再生研究(英文版)

基  金:supported in part by the NIH DA039530(to XJ);a grant from the CURE Epilepsy Foundation(to XJ)

摘  要:Hyperexcitability of neural network is a key neurophysiological mechanism in several neurological disorders including epilepsy, neuropathic pain, and tinnitus. Although standard paradigm of pharmacological management of them is to suppress this hyperexcitability, such as having been exemplified by the use of certain antiepileptic drugs, their frequent refractoriness to drug treatment suggests likely different pathophysiological mechanism. Because the pathogenesis in these disorders exhibits a transition from an initial activity loss after injury or sensory deprivation to subsequent hyperexcitability and paroxysmal discharges, this process can be regarded as a process of functional compensation similar to homeostatic plasticity regulation, in which a set level of activity in neural network is maintained after injury-induced activity loss through enhanced network excitability. Enhancing brain activity, such as cortical stimulation that is found to be effective in relieving symptoms of these disorders, may reduce such hyperexcitability through homeostatic plasticity mechanism. Here we review current evidence of homeostatic plasticity in the mechanism of acquired epilepsy, neuropathic pain, and tinnitus and the effects and mechanism of cortical stimulation. Establishing a role of homeostatic plasticity in these disorders may provide a theoretical basis on their pathogenesis as well as guide the development and application of therapeutic approaches through electrically or pharmacologically stimulating brain activity for treating these disorders.Hyperexcitability of neural network is a key neurophysiological mechanism in several neurological disorders including epilepsy, neuropathic pain, and tinnitus. Although standard paradigm of pharmacological man- agement of them is to suppress this hyperexcitability, such as having been exemplified by the use of certain antiepileptic drugs, their frequent refractoriness to drug treatment suggests likely different pathophysiological mechanism. Because the pathogenesis in these disorders exhibits a transition from an initial activity loss after injury or sensory deprivation to subsequent hyperexcitability and paroxysmal discharges, this process can be regarded as a process of functional compensation similar to homeostatic plasticity regulation, in which a set level of activity in neural network is maintained after injury-induced activity loss through enhanced network excitability. Enhancing brain activity, such as cortical stimulation that is found to be effective in relieving symptoms of these disorders, may reduce such hyperexcitability through homeostatic plasticity mechanism. Here we review current evidence of homeostatic plasticity in the mechanism of acquired ep- ilepsy, neuropathic pain, and tinnitus and the effects and mechanism of cortical stimulation. Establishing a role of homeostatic plasticity in these disorders may provide a theoretical basis on their pathogenesis as well as guide the development and application of therapeutic approaches through electrically or pharma- cologically stimulating brain activity for treating these disorders.

关 键 词:homeostatic plasticity EPILEPSY neuropathic pain cerebral cortex HYPEREXCITABILITY brain injury TINNITUS cortical stimulation 

分 类 号:R741[医药卫生—神经病学与精神病学]

 

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