Alzheimer型認知症に対する反復経頭蓋磁気刺激療法の臨床応用
Alzheimer型認知症（Alzheimer's Disease；AD）は，シナプス活動の低下による脳内回路破綻が認知機能障害を引き起こす原因ともされており，シナプス機能の改善を目指した治療法が注目されつつある．反復経頭蓋磁気刺激（repetitive transcranial magnetic stimulation；rTMS）は，シナプスの可塑性に注目した非侵襲脳刺激療法であり，ADを含む神経変性疾患へのニューロモデュレーション治療としての応用が期待されている．近年，海外からADに対する臨床研究の報告が増加しており，新たな治療アプローチとして注目されている．rTMSについて解説...
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| Published in | 神経治療学 Vol. 35; no. 2; pp. 113 - 117 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本神経治療学会
2018
Japanese Society of Neurological Therapeutics |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0916-8443 2189-7824 |
| DOI | 10.15082/jsnt.35.2_113 |
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| Abstract | Alzheimer型認知症（Alzheimer's Disease；AD）は，シナプス活動の低下による脳内回路破綻が認知機能障害を引き起こす原因ともされており，シナプス機能の改善を目指した治療法が注目されつつある．反復経頭蓋磁気刺激（repetitive transcranial magnetic stimulation；rTMS）は，シナプスの可塑性に注目した非侵襲脳刺激療法であり，ADを含む神経変性疾患へのニューロモデュレーション治療としての応用が期待されている．近年，海外からADに対する臨床研究の報告が増加しており，新たな治療アプローチとして注目されている．rTMSについて解説するとともに，ADに対するrTMSの最近の臨床報告について紹介する． |
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| AbstractList | 〔要約〕Alzheimer型認知症(Alzheimer's Disease ; AD)は, シナプス活動の低下による脳内回路破綻が認知機能障害を引き起こす原因ともされており, シナプス機能の改善を目指した治療法が注目されつつある. 反復経頭蓋磁気刺激(repetitive transcranial magnetic stimulation ; rTMS)は, シナプスの可塑性に注目した非侵襲脳刺激療法であり, ADを含む神経変性疾患へのニューロモデュレーション治療としての応用が期待されている. 近年, 海外からADに対する臨床研究の報告が増加しており, 新たな治療アプローチとして注目されている. rTMSについて解説するとともに, ADに対するrTMSの最近の臨床報告について紹介する. In Alzheimer's disease, synaptic activity goes haywire and brain networks gradually falter. The non–invasive brain stimulation, which modulate the brain functional connectivity, may be a novel therapy. The repetitive transcranial magnetism stimulation (rTMS) is the application as the neuromodulation treatment to neurodegenerative disease including Alzheimer's disease. rTMS might be improved the cognitive function to increase the release of neurotransmitter and induce the synapse plasticity of the in the brain. The recent some reports suggested a favorable effect and safe of rTMS on cognitive function with Alzheimer's disease patients. These promising results remain to be confirmed in controlled studies based on a larger population size. Furthermore, well–designed studies warranted to determine the neural plasticity changes induced by rTMS. Alzheimer型認知症（Alzheimer's Disease；AD）は，シナプス活動の低下による脳内回路破綻が認知機能障害を引き起こす原因ともされており，シナプス機能の改善を目指した治療法が注目されつつある．反復経頭蓋磁気刺激（repetitive transcranial magnetic stimulation；rTMS）は，シナプスの可塑性に注目した非侵襲脳刺激療法であり，ADを含む神経変性疾患へのニューロモデュレーション治療としての応用が期待されている．近年，海外からADに対する臨床研究の報告が増加しており，新たな治療アプローチとして注目されている．rTMSについて解説するとともに，ADに対するrTMSの最近の臨床報告について紹介する． Alzheimer型認知症（Alzheimer's Disease；AD）は，シナプス活動の低下による脳内回路破綻が認知機能障害を引き起こす原因ともされており，シナプス機能の改善を目指した治療法が注目されつつある．反復経頭蓋磁気刺激（repetitive transcranial magnetic stimulation；rTMS）は，シナプスの可塑性に注目した非侵襲脳刺激療法であり，ADを含む神経変性疾患へのニューロモデュレーション治療としての応用が期待されている．近年，海外からADに対する臨床研究の報告が増加しており，新たな治療アプローチとして注目されている．rTMSについて解説するとともに，ADに対するrTMSの最近の臨床報告について紹介する． |
| Author | 齋藤, 洋一 眞野, 智生 |
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| References | 10) Ahmed MA, Darwish ES, Khedr EM et al : Effects of low versus high frequencies of repetitive transcranial magnetic stimulation on cognitive function and cortical excitability in Alzheimer's dementia. J Neurol 259 : 83–92, 2012 9) Cotelli M, Manenti R, Cappa SF et al : Transcranial magnetic stimulation improves naming in Alzheimer disease patients at different stages of cognitive decline. Eur J Neurol 15 : 1286–1292, 2008 20) Rabey JM, Dobronevsky E : Repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training is a safe and effective modality for the treatment of Alzheimer's disease : clinical experience. J Neural Transm (Vienna) 123 : 1449–1455, 2013 11) Cotelli M, Calabria M, Manenti R et al : Improved language performance in Alzheimer disease following brain stimulation. J Neurol Neurosurg Psychiatry. 82 : 794–797, 2011 3) Lenz M, Galanis C, Müller–Dahlhaus F et al : Repetitive magnetic stimulation induces plasticity of inhibitory synapses. Nat Commun 7 : 10020, 2016 15) Eliasova I, Anderkova L, Marecek R et al : Non–invasive brain stimulation of the right inferior frontal gyrus may improve attention in early Alzheimer's disease : a pilot study. J Neurol Sci 346 (1–2) : 318–322, 2014 21) Lefaucheur JP et al : Evidence–based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol 125 : 2150–2206, 2014 1) 認知症疾患診療ガイドライン作成委員会：認知症疾患診療ガイドライン2017，東京，医学書院，pp10–15，2017 7) Hsu WY, Ku Y, Zanto TP et al : Effects of noninvasive brain stimulation on cognitive function in healthy aging and Alzheimer's disease : a systematic review and meta–analysis. Neurobiol Aging 36 : 2348–2359, 2015 4) Ueyama E, Ukai S, Ogawa A et al : Chronic repetitive transcranial magnetic stimulation increases hippocampal neurogenesis in rats. Psychiatry Clin Neurosci 65 : 77–81, 2011 8) Cotelli M, Manenti R, Cappa SF et al : Effect of transcranial magnetic stimulation on action naming in patients with Alzheimer disease. Arch Neurol 63 : 1602–1604, 2006 6) 松本英之，宇川義一，臨床神経生理学会脳刺激の安全性に関する委員会：磁気刺激法の安全性に関するガイドライン．臨神生 39 : 34–45, 2011 17) Rabey JM, Dobronevsky E, Aichenbaum S et al : Repetitive transcranial magnetic stimulation combined with cognitive training is a safe and effective modality for the treatment of Alzheimer's disease : a randomized, double–blind study. J Neural Transm (Vienna) 120 : 813–819, 2013 19) Lee J, Choi BH, Oh E et al : Treatment of Alzheimer's Disease with Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training : A Prospective, Randomized, Double–Blind, Placebo–Controlled Study. J Clin Neurol 12 : 57–64, 2016 5) Shojaei A, Semnanian S, Janahmadi M et al : Repeated transcranial magnetic stimulation prevents kindling–induced changes in electrophysiological properties of rat hippocampal CA1 pyramidal neurons. J. Neuroscience 280 : 181–192, 2014 14) Turriziani P, Smirni D, Zappalà G et al : Enhancing memory performance with rTMS in healthy subjects and individuals with Mild Cognitive Impairment : the role of the right dorsolateral prefrontal cortex. Front Hum Neurosci 6 : 62, 2012 2) Chervyakov AV, Chernyavsky AY, Sinitsyn DO et al : Possible Mechanisms Underlying the Therapeutic Effects of Transcranial Magnetic Stimulation. Front Hum Neurosci 9 : 303, 2015 12) Haffen E, Chopard G, Pretalli JB et al : A case report of daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) as an adjunctive treatment for Alzheimer disease. Brain Stimul 5 : 264–266, 2012 16) Bentwich J, Dobronevsky E, Aichenbaum S et al : Beneficial effect of repetitive transcranial magnetic stimulation combined with cognitive training for the treatment of Alzheimer's disease : a proof of concept study. J Neural Transm (Vienna) 118 : 463–471, 2011 18) Nguyen JP, Suarez A, Kemoun G et al : Repetitive transcranial magnetic stimulation combined with cognitive training for the treatment of Alzheimer's disease. Neurophysiol Clin 47 : 47–53, 2017 13) Liao X, Li G, Wang A et al : Repetitive Transcranial Magnetic Stimulation as an Alternative Therapy for Cognitive Impairment in Alzheimer's Disease : A Meta–Analysis. J Alzheimers Dis 48 : 463–472, 2015 |
| References_xml | – reference: 7) Hsu WY, Ku Y, Zanto TP et al : Effects of noninvasive brain stimulation on cognitive function in healthy aging and Alzheimer's disease : a systematic review and meta–analysis. Neurobiol Aging 36 : 2348–2359, 2015 – reference: 13) Liao X, Li G, Wang A et al : Repetitive Transcranial Magnetic Stimulation as an Alternative Therapy for Cognitive Impairment in Alzheimer's Disease : A Meta–Analysis. J Alzheimers Dis 48 : 463–472, 2015 – reference: 19) Lee J, Choi BH, Oh E et al : Treatment of Alzheimer's Disease with Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training : A Prospective, Randomized, Double–Blind, Placebo–Controlled Study. J Clin Neurol 12 : 57–64, 2016 – reference: 20) Rabey JM, Dobronevsky E : Repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training is a safe and effective modality for the treatment of Alzheimer's disease : clinical experience. J Neural Transm (Vienna) 123 : 1449–1455, 2013 – reference: 3) Lenz M, Galanis C, Müller–Dahlhaus F et al : Repetitive magnetic stimulation induces plasticity of inhibitory synapses. Nat Commun 7 : 10020, 2016 – reference: 16) Bentwich J, Dobronevsky E, Aichenbaum S et al : Beneficial effect of repetitive transcranial magnetic stimulation combined with cognitive training for the treatment of Alzheimer's disease : a proof of concept study. J Neural Transm (Vienna) 118 : 463–471, 2011 – reference: 10) Ahmed MA, Darwish ES, Khedr EM et al : Effects of low versus high frequencies of repetitive transcranial magnetic stimulation on cognitive function and cortical excitability in Alzheimer's dementia. J Neurol 259 : 83–92, 2012 – reference: 17) Rabey JM, Dobronevsky E, Aichenbaum S et al : Repetitive transcranial magnetic stimulation combined with cognitive training is a safe and effective modality for the treatment of Alzheimer's disease : a randomized, double–blind study. J Neural Transm (Vienna) 120 : 813–819, 2013 – reference: 14) Turriziani P, Smirni D, Zappalà G et al : Enhancing memory performance with rTMS in healthy subjects and individuals with Mild Cognitive Impairment : the role of the right dorsolateral prefrontal cortex. Front Hum Neurosci 6 : 62, 2012 – reference: 15) Eliasova I, Anderkova L, Marecek R et al : Non–invasive brain stimulation of the right inferior frontal gyrus may improve attention in early Alzheimer's disease : a pilot study. J Neurol Sci 346 (1–2) : 318–322, 2014 – reference: 9) Cotelli M, Manenti R, Cappa SF et al : Transcranial magnetic stimulation improves naming in Alzheimer disease patients at different stages of cognitive decline. Eur J Neurol 15 : 1286–1292, 2008 – reference: 8) Cotelli M, Manenti R, Cappa SF et al : Effect of transcranial magnetic stimulation on action naming in patients with Alzheimer disease. Arch Neurol 63 : 1602–1604, 2006 – reference: 1) 認知症疾患診療ガイドライン作成委員会：認知症疾患診療ガイドライン2017，東京，医学書院，pp10–15，2017 – reference: 4) Ueyama E, Ukai S, Ogawa A et al : Chronic repetitive transcranial magnetic stimulation increases hippocampal neurogenesis in rats. Psychiatry Clin Neurosci 65 : 77–81, 2011 – reference: 5) Shojaei A, Semnanian S, Janahmadi M et al : Repeated transcranial magnetic stimulation prevents kindling–induced changes in electrophysiological properties of rat hippocampal CA1 pyramidal neurons. J. Neuroscience 280 : 181–192, 2014 – reference: 12) Haffen E, Chopard G, Pretalli JB et al : A case report of daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) as an adjunctive treatment for Alzheimer disease. Brain Stimul 5 : 264–266, 2012 – reference: 2) Chervyakov AV, Chernyavsky AY, Sinitsyn DO et al : Possible Mechanisms Underlying the Therapeutic Effects of Transcranial Magnetic Stimulation. Front Hum Neurosci 9 : 303, 2015 – reference: 21) Lefaucheur JP et al : Evidence–based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol 125 : 2150–2206, 2014 – reference: 11) Cotelli M, Calabria M, Manenti R et al : Improved language performance in Alzheimer disease following brain stimulation. J Neurol Neurosurg Psychiatry. 82 : 794–797, 2011 – reference: 6) 松本英之，宇川義一，臨床神経生理学会脳刺激の安全性に関する委員会：磁気刺激法の安全性に関するガイドライン．臨神生 39 : 34–45, 2011 – reference: 18) Nguyen JP, Suarez A, Kemoun G et al : Repetitive transcranial magnetic stimulation combined with cognitive training for the treatment of Alzheimer's disease. Neurophysiol Clin 47 : 47–53, 2017 |
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| Snippet | Alzheimer型認知症（Alzheimer's Disease；AD）は，シナプス活動の低下による脳内回路破綻が認知機能障害を引き起こす原因ともされており，シナプス機能の改善を目指した... 〔要約〕Alzheimer型認知症(Alzheimer's Disease ; AD)は, シナプス活動の低下による脳内回路破綻が認知機能障害を引き起こす原因ともされており, シナプス機能の改善を目... In Alzheimer's disease, synaptic activity goes haywire and brain networks gradually falter. The non–invasive brain stimulation, which modulate the brain... |
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| Title | Alzheimer型認知症に対する反復経頭蓋磁気刺激療法の臨床応用 |
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