电刺激Meynert基底核对阿尔茨海默病脑网络的调控作用  

Regulatory effect of deep brain stimulation of the nucleus basalis of Meynert on brain networks in Alzheimer's disease

作　　者：张艳阳[1] 许军鹏 毛之奇[1] 余新光[1] 张剑宁 ZHANG Yanyang;XU Junpeng;MAO Zhiqi;YU Xinguang;ZHANG Jianning(Department of Neurosurgery,The First Medical Center,Institute of Neurosurgery,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院:第一医学中心神经外科医学部,神经外科研究所,北京100853

出　　处：《空军军医大学学报》2025年第3期286-291,共6页Journal of Air Force Medical University

基　　金：国家自然科学基金青年科学基金(82001798);国家自然科学基金面上项目(81871087);科技部科技创新2030“脑科学与类脑科学”重大项目(2021ZD0200407);解放军总医院“3+1”青年科技英才培育项目(20230403);解放军总医院神经外科医学部创新研究孵化课题(SWXB-FH-004)。

摘　　要：目的从脑网络层面探索脑深部电刺激(DBS)Meynert基底核(NBM)对阿尔茨海默病(AD)的调控作用。方法分析2016年1月至2022年12月收治的接受低频NBM-DBS治疗的5例重度AD患者术前和术后多模态影像学数据,进行电极位置重建和组织激活体积(V_(TA)),构建电刺激NBM的脑网络连接图。结果5例NBM-DBS手术的术后随访无感染、电极移位、出血等手术相关并发症,确定了基于机器人辅助下NBM-DBS治疗AD植入手术流程。实现术后空间结构的三维可视化,可显示电极和靶点核团的空间位置关系,并从多个角度确认电极触点的精确位置。右侧电极触点的V_(TA)为(146.89±18.96)mm^(3),左侧电极触点的V_(TA)为(139.67±29.98)mm^(3)。电刺激NBM相关的脑功能网络主要涉及位于默认网络(占21.83%)、腹侧注意网络(占15.07%)和皮层下核团的脑区(占12.36%),提示NBM与皮层下核团和高级认知网络存在信息交流。结论NBM到大脑皮层、杏仁核等具有广泛的功能连接,这些网络可能是NBM-DBS治疗AD的功能基础。Objective To explore the regulatory effect of deep brain stimulation(DBS)of the nucleus basalis of Meynert(NBM)on Alzheimer's disease(AD)at the level of brain networks.Methods The preoperative and postoperative multimodal imaging data of 5 patients with severe AD who received low-frequency NBM-DBS treatment from January 2016 to December 2022 were analyzed.Electrode position reconstruction and volume of tissue activated(V_(TA))were performed to construct brain network connectivity maps of electrically stimulated NBM.Results The postoperative follow-up of 5 cases of NBM-DBS surgery showed no postoperative complications such as infection,electrode displacement and bleeding.A robot-assisted NBM-DBS treatment procedure for AD implantation surgery was determined.The three-dimensional visualization of postoperative spatial structure was realized,which could display the spatial position relationship between electrodes and target nuclei and confirm the precise position of electrode contacts from multiple angles.The V_(TA)of the right electrode contact was(146.89±18.96)mm^(3),and the V_(TA)of the left electrode contact was(139.67±29.98)mm^(3).The brain functional networks related to electrical stimulation of NBM mainly involved brain regions located in the default network(21.83%),ventral attention network(15.07%),and subcortical nuclei(12.36%),indicating information exchange between NBM and subcortical nuclei and higher cognitive networks.Conclusion NBM has extensive functional connections to cerebral cortex,amygdala,and other regions,which may serve as the functional basis for NBM-DBS treatment of AD.

关 键 词：阿尔茨海默病 脑深部电刺激 MEYNERT基底核 脑网络 

分 类 号：R749.16[医药卫生—神经病学与精神病学]