对无创脑刺激神经调控技术分类的思考

Thinking on the classification of non-invasive brain stimulation as neuromodulation technique

神经调控技术已由原来的电刺激或化学性手段逐渐演变为包括电、磁、声、光、热等各种各样的物理刺激技术,但每种刺激技术或范式的临床疗效和机制差异很大。为了便于理解不同神经调控的疗效和机制,结合目前的临床实践,本文以当前无创经颅电刺激的分类为例,提出了以能量大小为首级分类,不同介质为次级分类的观点。本观点强调了各种物理刺激的能量本质,其次是物理刺激的传递载体。这种分类方法有助于指导和设计针对不同靶症状的神经调控范式,有利于更好地服务临床诊疗。文中还讨论了各类技术的优劣及临床应用。

Neuromodulation techniques have gradually evolved from electrical or chemical methods to various physical stimulation techniques including electricity,magnetism,sound,light,heat,and more.However,the clinical efficacy and mechanisms of each stimulation technique or paradigm vary greatly.To facilitate the understanding of the therapeutic effects and mechanisms of different neuromodulation techniques,combined with current clinical practice,the author takes the classification of non-invasive transcranial electrical stimulation as an example and proposes the idea of using energy magnitude as the primary classification and different media/stimulation routes as the secondary classification.This classification emphasizes the energy essence of various physical stimuli,followed by the transmission carriers of physical stimuli.This classification method helps to guide and design neuromodulation paradigms for different target symptoms in various brain disorders,which is beneficial for better serving clinical diagnosis and treatment.The Expert Forum also discusses the advantages and disadvantages of various neuromodulation technologies and their clinical applications.