Метапластичность и неинвазивная стимуляция мозга: поиск новых биомаркеров и направлений терапевтической нейромодуляции

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Аннотация

Метапластичность (пластичность синаптической пластичности) определяется как изменение направленности или выраженности синаптической пластичности в ответ на предшествующую нейрональную активность. Активное развитие в последние годы методов стимуляции мозга позволяет изучать метапластичность коры неинвазивно, в том числе в клинических условиях. Согласно современным представлениям, эффект неинвазивной нейромодуляции основан на её влиянии на синаптическую пластичность за счёт индукции в коре процессов, сходных с долговременной потенциацией и депрессией. Для оценки метапластичности обычно используются 2 блока стимуляции — прайминговый и тестовый. Суть технологии изучения метапластичности состоит в оценке влияния прайминга на эффект тестового протокола.

В нескольких десятках исследований изучены эффекты различных комбинаций протоколов стимуляции у здоровых лиц, при этом показано, что прайминг может как усиливать, так и ослаблять или даже менять направленность эффекта тестового протокола. Особенности взаимодействия прайминговой и тестовой стимуляции зависят от многих факторов: направленности их эффекта, продолжительности блоков стимуляции и интервала между ними.

Неинвазивная стимуляция мозга может использоваться для оценки аберрантной метапластичности при заболеваниях нервной системы с целью разработки новых биомаркеров. Нарушения метапластичности выявляются при писчем спазме, мигрени с аурой, рассеянном склерозе, хронических нарушениях сознания и возрастных когнитивных нарушениях.

Большие перспективы связаны с разработкой новых, основанных на метапластичности оптимизированных комбинированных протоколов стимуляции для использования терапевтической нейромодуляции в клинической практике.

Об авторах

Илья Сергеевич Бакулин

ФГБНУ «Научный центр неврологии»

Автор, ответственный за переписку.
Email: bakulinilya@gmail.com
ORCID iD: 0000-0003-0716-3737

к.м.н., н.с., рук. группы неинвазивной нейромодуляции Института нейрореабилитации и восстановительных технологий

Россия, Москва

Александра Георгиевна Пойдашева

ФГБНУ «Научный центр неврологии»

Email: alexandra.poydasheva@gmail.com
ORCID iD: 0000-0003-1841-1177

м.н.с. группы неинвазивной нейромодуляции Института нейрореабилитации и восстановительных технологий

Россия, Москва

Альфия Ходжаевна Забирова

ФГБНУ «Научный центр неврологии»

Email: alfijasabirowa@gmail.com
ORCID iD: 0000-0001-8544-3107

аспирант, врач-невролог

Россия, Москва

Наталья Александровна Супонева

ФГБНУ «Научный центр неврологии»

Email: nasu2709@mail.ru
ORCID iD: 0000-0003-3956-6362

д.м.н., профессор, член-корреспондент РАН, директор Института нейрореабилитации и восстановительных технологий

Россия, Москва

Михаил Александрович Пирадов

ФГБНУ «Научный центр неврологии»

Email: Mpi711@gmail.com
ORCID iD: 0000-0002-6338-0392

д.м.н., профессор, академик РАН, директор

Россия, Москва

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