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Personalised image-guided noninvasive brain stimulation in gliomas: Rationale challenges and opportunities

机译:Gliomas的个性化图像引导非血管脑刺激:理由挑战和机遇

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摘要

Malignant brain tumours are among the most aggressive human cancers, and despite intensive efforts made over the last decades, patients’ survival has scarcely improved. Recently, high-grade gliomas (HGG) have been found to be electrically integrated with healthy brain tissue, a communication that facilitates tumour mitosis and invasion. This link to neuronal activity has provided new insights into HGG pathophysiology and opened prospects for therapeutic interventions based on electrical modulation of neural and synaptic activity in the proximity of tumour cells, which could potentially slow tumour growth. Noninvasive brain stimulation (NiBS), a group of techniques used in research and clinical settings to safely modulate brain activity and plasticity via electromagnetic or electrical stimulation, represents an appealing class of interventions to characterise and target the electrical properties of tumour-neuron interactions. Beyond neuronal activity, NiBS may also modulate function of a range of substrates and dynamics that locally interacts with HGG (e.g., vascular architecture, perfusion and blood-brain barrier permeability). Here we discuss emerging applications of NiBS in patients with brain tumours, covering potential mechanisms of action at both cellular, regional, network and whole-brain levels, also offering a conceptual roadmap for future research to prolong survival or promote wellbeing via personalised NiBS interventions.
机译:恶性脑肿瘤是最具侵略性的人类癌症之一,尽管在过去几十年中取得了密集的努力,但患者的生存率几乎没有得到改善。最近,已发现高级胶质瘤(HGG)与健康的脑组织电集成,这是一种促进肿瘤有丝分裂和侵袭的沟通。该链接到神经元活动已经为HGG病理生理学和基于肿瘤细胞附近的神经和突触活动的电调节的治疗干预的开放前景提供了新的洞察,这可能会缓慢肿瘤生长缓慢。非侵入性脑刺激(NIBS),用于通过电磁或电刺激安全地调节脑活动和可塑性的研究和临床环境中的一组技术代表了表征和靶向肿瘤 - 神经元相互作用的电学性质的吸引力。除了神经元活动之外,NIBs还可以调节各种底物和动态的功能,所述基质和动力学与HGG(例如,血管结构,灌注和血脑屏障渗透率)相互作用。在这里,我们讨论了NIBS在脑肿瘤患者中的新兴应用,涵盖了细胞,区域,网络和全脑水平的潜在作用机制,也为未来的研究提供了概念性的路线图,以通过个性化的尖端干预延长生存或促进幸福。

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