去甲肾上腺素通路的研究进展及其在迷走神经电刺激改善难治性癫痫学习记忆中的潜在作用  

Research progress of norepinephrine pathway and its potential role in vagus nerve stimulation-improved learning and memory in refractory epilepsy

作　　者：王君 魏景宽 戚仁莉 白萤萤 裴鸿龙 余化霖[1] WANG Jun;WEI Jing-Kuan;QI Ren-Li;BAI Ying-Ying;PEI Hong-Long;YU Hua-Lin(Department of Minimally Invasive Neurosurgery,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Institute of Primate Translational Medicine,State Key Laboratory of Nonhuman Primate Biomedical Sciences,Kunming University of Science and Technology,Kunming 650500,China;Department of Laboratory Medicine,The Sixth Affiliated Hospital of Kunming Medical University,Yuxi 653100,China)

机构地区：[1]昆明医科大学第一附属医院微创神经外科,昆明650032 [2]昆明理工大学灵长类转化医学研究院,省部共建非人灵长类生物医学国家重点实验室,昆明650500 [3]昆明医科大学第六附属医院检验科,玉溪653100

出　　处：《生命科学》2023年第5期678-688,共11页Chinese Bulletin of Life Sciences

基　　金：国家重点研发计划干细胞专项(2018YFA0108503);云南省基础研究计划面上项目(202101AT070278);云南省卫生健康委员会名医专项云南省“高层次人才培养支持计划”(KYRLMY20200026);云南省卫生健康委员会科技人才与平台计划(202105AC160029);云南省神经系统疾病临床医学研究中心基于脑血管疾病及认知功能障碍的相关研究(202002AA100204)。

摘　　要：迷走神经电刺激(vagus nerve stimulation, VNS)对无法手术的耐药难治性癫痫患者能起到较好的抗癫痫效果,目前已被美国FDA批准用于耐药难治性癫痫的临床辅助性治疗。VNS的抗癫痫作用可长期维持,且治疗效果随刺激时间的延长而增加。有研究发现,VNS在减少癫痫发作的同时,还能改善癫痫患者的情绪状态,提高患者的认知能力。去甲肾上腺素能系统参与突触可塑性调节。本文综述了VNS改善难治性癫痫患者学习记忆能力的研究进展,重点讨论了去甲肾上腺素能系统调控突触可塑性变化的相关信号通路,提出VNS激活去甲肾上腺素能系统从而改善患者学习记忆的潜在可能性,为临床癫痫治疗提供新的靶点和思路。Vagus nerve stimulation(VNS)has shown an obvious anti-epileptic effect on patients with drug-resistant refractory epilepsy(DRE)and has been approved by the US FDA to clinically treat DRE as a supplementary approach.The antiepileptic effect of VNS could be maintained for a long time and strengthened by increasing the duration of electrical stimulation.More and more studies have shown that VNS not only reduces seizures but also improves the emotional state and cognition of epileptic patients.The norepinephrine(NE)system is involved in synaptic plasticity regulation.In this review,we summarize the recent progress of VNS in improving the learning and memory ability of DRE patients and introduce the main signaling pathways of the NE system in regulating synaptic plasticity.Further,we propose a potential possibility of improving learning and memory by activating the NE system in DRE patients after VNS treatment,which provides a new target and thinking basis for clinical epilepsy treatment.

关 键 词：癫痫 迷走神经电刺激(VNS) 去甲肾上腺素能系统 Β-肾上腺素受体 Α-肾上腺素受体 

分 类 号：Q42[生物学—神经生物学] R742.1[生物学—生理学]