通过药理疗法恢复意识:机制,目标和未来方向
Megan E Barra1, Ken Solt2, Xin Yu3
1Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA; Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA.
概括
针对神经递质系统的药理疗法在严重脑损伤后有望改善意识. 了解这些系统是开发个性化治疗意识障碍 (DoC) 的关键.
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
- 神经化学 神经化学
背景情况:
- 严重的脑损伤通过影响多个神经递质系统来破坏意识.
- 目前的治疗包括阿曼塔丁和非标记的神经刺激剂,但最佳疗法不是个性化的.
- 各种神经递质系统在恢复意识中的作用仍然不清楚.
研究的目的:
- 审查涉及意识的神经递质系统的神经化学和神经生物学.
- 讨论促进恢复意识的药理学调制策略.
- 探索意识促进的中电路模型.
主要方法:
- 关于与意识有关的神经化学,神经生物学和药理学的文献综述.
- 对神经递质系统的分析,包括单氨基,谷氨基,胆固醇,GABAergic和Orexinergic.
- 在突触,电路和网络层面讨论治疗目标.
主要成果:
- 证据支持药理学调节,特别是多巴胺,用于恢复意识.
- 使用了阿曼塔丁,甲基酸和莫达菲尼尔等各种药物,但它们的确切机制仍在调查中.
- 中介电路模型为理解不同神经递质系统如何影响意识提供了一个框架.
结论:
- 药理疗法具有显著的潜力,可以改善有意识障碍的患者的治疗结果.
- 需要进一步的研究来阐明神经递质机制,并使个性化治疗选择成为可能.
- 有针对性的药理干预可以提高严重脑损伤后的康复和生活质量.
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