基线功能连接性预测谁将受益于神经调节:从初级渐进性失语症的证据
Zeyi Wang1, Jessica Gallegos2, Donna Tippett1,2,3
1Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA.
概括
功能连接,而不是临床因素,最好预测谁受益于初级渐进性失语症 (PPA) 的跨直流刺激 (tDCS). 在特定的大脑区域的更高的基线连接性表明对tDCS治疗的反应更大.
科学领域:
- 神经科学是一个神经科学.
- 神经调节是一种神经调节.
- 精准医学是一门精准的医学.
背景情况:
- 初级渐进性失语症 (PPA) 是一种罕见的,异质的神经退行性疾病.
- 预测PPA的治疗反应是具有挑战性的,因为不同的临床表现.
- 识别响应者对于优化干预措施至关重要,例如横直流刺激 (tDCS).
研究的目的:
- 确定患者特征,预测PPA中对左下额头 (IFG) tDCS的反应.
- 为了比较临床因素与tDCS结果的功能连接的预测值.
- 开发一种用于PPA神经调节的精密医学方法.
主要方法:
- 对比人口统计和临床数据 (PPA变种,进展,基线语言) 与静止状态功能连接 (fMRI).
- 使用了一种新的异质性和群体识别分析.
- 对tDCS对语义流性和书面命名的影响进行预测.
主要成果:
- 仅仅功能连接是tDCS结果最强的预测因素.
- 功能连接性解释了语义流性差异的62%,书面命名差异的75%.
- 左侧的IFG和形-形区域之间的更高的基线连接预测了更大的tDCS好处.
- 临床特征预测tDCS治疗效果的<15%.
结论:
- 基线7分钟的功能连接扫描对于预测tDCS结果至关重要.
- 这种方法可以为神经调节试验和临床实践精确选择患者.
- 解决人口异质性的统计方法可以提高针对性干预措施的预测准确性.
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