Le Nqubo Yobuningi Ivame Ukusetshenziselwa Ukwelapha Izifo Zase-Parkinson
Kuzwakala sengathi kukhona okuvela kubenzi be-Star Trek, kodwa abacwaningi babona amathuba okuvela ngokusebenzisa ukukhushulwa kobuchopho obujulile kubantu abane- Alzheimer's mildness . Futhi, ezweni lapho imithi itholakala khona kodwa izinzuzo zilinganiselwe, kubalulekile ukuqhubeka nokuthuthukisa ezinye izindlela zokwelashwa ukuphatha nokuvimbela i-Alzheimer's.
Kuyini Ukuqothulwa Kwebhongo Okujulile?
Ukuvuthwa Okujulile Kwebhongo (DBS) yinkqubo lapho ama-electrode abekwa khona ngaphakathi kobuchopho futhi ahlelwe ukunikeza amantombazane amancane kagesi ukuvuselela umsebenzi wobuchopho.
I-DBS isetshenziswe iminyaka eminingana abantu abanesifo sikaParkinson benempumelelo enkulu ekunciphiseni ukukhushulwa kwemisipha nokuhlukumeza imisipha, kanye nokuthuthukisa ukuma. Kubuye kuphandwe ukuphatha ezinye izimo zezokwelapha, njengokucindezeleka nokucindezeleka okucindezelayo .
Ama-electrodes afakwa kanjani ebuchosheni?
Impendulo emifushane: ukuhlinzwa kobuchopho. Ukuze i-DBS ibe khona, izintambo kufanele zifakwe ebuchosheni. Ukusebenzisa i- anesthesia yasendaweni , izimbobo ze-neurosurgeon zifaka izimbobo ezingxenyeni zegulane futhi zithinta ngokucophelela izintambo ezindaweni ezihlukahlukene zobuchopho. (I-anesthesia yasekhaya, lapho isiguli siphapheme kodwa indawo yomzimba ivinjelwe, ingasetshenziswa ngoba ubuchopho ngokwayo abuzwa ubuhlungu.)
Umshini we-pacemaker-like uhlanganiswa ngaphansi kwe-anesthhesia ejwayelekile esifubeni somuntu lapho ekugcineni ungathumela khona imizwa engamakhulu ayisishiyagalolunye kagesi kagesi ngomzuzwana kuya ezintambo futhi, ngenxa yalokho, ubuchopho. Lapho uqale ukufakwa, i-stimulator ivaliwe; izinsuku ezimbalwa noma amasonto emva kokuhlinzwa, i-stimulator ivuliwe futhi iqala ukuletha izifiso zombane ebuchosheni.
Uma isetshenziselwa ukuphatha isifo se-Alzheimer, lezo zinsambo zivame ukuxhunyaniswa ne-fornix ebuchosheni. Ngokusho kukaJohn Hopkins Medicine, "i-fornix iyindlela yokuhlola ebuchosheni ekuletheleni ulwazi ku- hippocampus , ingxenye yengqondo lapho kuqala khona ukufunda nokukhumbula , nalapho izimpawu zokuqala ze -Alzheimer zivela khona."
Umsebenzi Wokuvuselela Ubuntu Obukhulu
Kunemibono eminingi yokuthi kungani isebenza, kodwa ayikho impendulo eqondile okwamanje. E-Parkinson, kucatshangwa ukuphazamisa nokuphazamisa ukudubula okungafaneleki kobuchopho.
Eqinisweni, ukucwaninga kwe-DBS ukucwaningwa kwabacwaningi kuncishisiwe kangangokuthi kungenzeka ukuthi ukusebenzisa i-Alzheimer sika kwenzeka ngengozi lapho i-DBS ivivinywa kumuntu owayeseqile ngokweqile njengendlela yokuzama ukulawula ukudla kwakhe. Njengoba beyivivinya nge-placement wire kanye nemigomo kagesi, wabika imemori ecacile. Lapho bevala izimpendulo, inkumbulo yaphela, futhi lapho iphendulela i-stimulator, inkumbulo ibuyele. Lokhu kwaholela ekuqapheliseni ukuthi mhlawumbe kunendlela yokuvuselela ubuchopho kanye nezinkumbulo ezithintekayo.
Ingabe Kuphephile?
I-DBS ibonakala iphephile. Nakuba ukucwaninga kokuhlinzwa kobuchopho kubonakala kunengozi kakhulu, ochwepheshe bathi le nqubo empeleni ayinasisindo njengoba kuzwakala.
Kukhona izingozi njalo nokuhlinzwa kobuchopho; Kodwa-ke, abantu abangaphezu kuka-100 000 emhlabeni jikelele abanesifo sikaParkinson baye bahlangabezana ne-DBS ngezinkinga ezincane. Izingozi zifaka ukutheleleka, ukusebenza kwemishini, ukushaya, ukuhluleka kwebhethri nokuhamba kwensimbi.
Ukucwaninga Nge-Deep Brain Ukukhuthazwa Nezifo Ze-Alzheimer's
I-Phase I Yokucwaninga
Ngo-2010, iphephandaba le-Annals of Neurology lanyathelisa ucwaningo oluchaza isilingo sesigaba se-I sokutholwa eCanada nabantu abayisithupha abathola ukuthi banesifo sokuqala se-Alzheimer's. Ngamunye wabo wayenomqondo ojulile wokuvuselela ubuchopho ebuchosheni babo futhi wabhekana nezinyanga ezingu-12 zokuvuselela kagesi okuqhubekayo.
Ukuhlolwa kokusebenza kwabo kwengqondo ezinyangeni ezingu-6 no-12 kubonise ukuthuthuka, noma ukuncipha okungaphansi kokulindeleke kwabahlanganyeli abathathu kwabayisithupha.
Ngaphezu kwalokho, izilinganiso ze-PET zazisetshenziselwa ukuhlola umzimba we-glucose we-cerebral, okuyinto ikhono lobuchopho lokuphula ushukela ophethweni lobuchopho futhi lungaba uphawu lwezinga lomsebenzi we-neurons ebuchosheni. Abantu abane-Alzheimer babonisa ukuncipha kwe-glucose metabolism ngokuhamba kwesikhathi, kodwa laba abacwaningi abacwaningi abayisithupha babonisa ukwanda okwakugcinwe kulo lonke ucwaningo. Ngokuthakazelisayo, ikhono elinciphisa ubuchopho lokuphuza ushukela e-Alzheimer's isifo esithile sabangela ukuthi abanye abacwaningi babize ngokuthi " uhlobo lwesifo sikashukela sika- 3 " lwe- Alzheimer.
Isigaba II Ucwaningo
Esikhathini sesigaba sesibili sifunda ngoJohn Hopkins, iziguli ezingama-42 ezineminyaka engu-45 kuya kwezingu-85 zahlanganyela ku-DBS ukuze zibheke isifo sabo se-Alzheimer's. Ngamunye wabo waba nomsebenzi we-DBS wokuhlinzekwa phakathi kuka-2012 no-2014. Ingxenye yazo yayinezikhukhula zabo emva kwamaviki amabili, kanti ingxenye yabo yavuleka emva kwezinyanga ezingu-12. Lokhu kwakuyizifundo ezimbili eziyimpumputhe, ngoba odokotela noma iziguli abazange bazi lapho izishukumisi zenziwe.
Ukucubungula kwahlolwa kulolu cwaningo ngokusebenzisa izivivinyo eziningi ezibandakanya i- ADAS-Cog 13. Ukusetshenziswa komzimba kwe-cerebral glucose kwakulinganiswa ezindaweni ezahlukene zobuchopho.
Imiphumela yalolu cwaningo yayithakazelisayo, hhayi ukuthi kwakulindeleke yini. Ezinyangeni eziyisithupha emva kokumiswa kwe-stimulator, imfucumfucu ye-glucose ye-cerebral yanda kakhulu, kodwa lezo zindleko azizange zisekelwe ezinyangeni ezingu-12. Ukwengeza, ukungafani okuhlobene iminyaka yobudala kwaphawulwa. Labo abathintekayo abaneminyaka engaphezu kwengu-65 babonise ukuthuthukiswa kokusebenza kwengqondo nokuhlukunyezwa kwe-glucose ye-cerebral. Labo abangaphansi kweminyaka engu-65 abazange babonise ukuthuthukiswa okukhulu kunoma iyiphi indawo. Abacwaningi bahlezi ukuthi lo mphumela kungenzeka ukuthi uhlobene nokuwohloka kwesakhiwo sobuchopho ngezinye izikhathi kubantu abasha abane-Alzheimer's ( ekuqaleni kokuqala kwe-Alzheimer's ), uma kuqhathaniswa nalabo abane-Alzheimer's early onset .
Isifinyezo se-DBS Effects ku-Brain
Imiphumela ye-DBS ku-Alzheimer's ihlolwe ngalezi zivivinyo zesigaba sesi-I nesigaba II, kepha ulwazi lokuthi kuthinta kanjani ubuchopho nalo luqoqwe kusukela ekusebenziseni kwezinye izilungiselelo, kuhlanganise nezinye izifundo zokucwaninga nokuphathwa kwesifo sika-Parkinson. Imiphumela elandelayo itholakale:
Ukwakheka komqondo jikelele okuthuthukisiwe: Ukucwaninga nge-DBS kubantu abane-Alzheimer kuholele ekuqinisekiseni abanye abahlanganyeli ukuqonda, njengoba kulinganiswa izivivinyo eziningi ze-neuropsychological . Lezi zivivinyo zikala izici eziningana zokusebenza kobuchopho, kufaka phakathi imemori, ukuqondisa , ukuqashelwa igama, nokuningi.
Ukwanda kwe-hippocampus ivolumu: Ngenkathi i-hippocampus (ingxenye yengqondo ehambisana nenkumbulo) i- atrophies ngokuguga nokubhebhetheka kakhulu kwesifo se-Alzheimer, i-DBS itholakale ukwandisa umthamo we-hippocampus kubantu abane-Alzheimer's. Ivolumu ye-Hippocampal ihlotshaniswe nokusebenza kwememori.
Ukwanda kwe-glucose ye-gerectic cerebral: Njengoba kuvezwe ngenhla, ezinye izifundo ezithola i-DBS zibonise ukuthuthukiswa kwe-glucose yokudla emzimbeni ezindaweni eziningi zobuchopho.
Umthamo owandayo we-fornix nezindikimba ezinamakhompiyutha: I-fornix nezindikimba ezinamakhompi ebuchosheni (okubili kokubili ezihlobene nokusebenza kwememori) zibonise ivolumu eyengeziwe ngemva kwe-DBS kulabo abane-Alzheimer's.
Amazinga aphezulu e-acetylcholine: I- DBS nayo iboniswe ocwaningweni ukuze iqale ukukhululwa kwe-acetylcholine. I-Acetylcholine isiza ukudlulisa imilayezo kusuka kwelinye iseli lesisindo kuya elilandelayo ebuchosini bethu.
Inkumbulo yendawo eyengeziwe: Emva kokukhushulwa kobuchopho obujulile ekutholeni amakhondomu, babonisa inkumbulo engcono yokumaketha ngokwazi kwabo ukuhamba ngendlela. Ngenkathi izifundo zezilwane zingahambi njalo kubantu, zivame ukusinikeza ulwazi mayelana nokuphepha nokusebenza kwezinqubo zokuhlola.
Ukunciphisa ukukhuluma ngokuzwakalayo: Ukukhushulwa kobuchopho obujulile sekusetshenziselwe iminyaka kubantu abaneParkinson abanemiphumela emihle kakhulu. Kodwa-ke, uphenyo oluthile luye lwabona ukuthi ukuzwakala komlomo kuye kwehla kwabanye balaba bantu. Nakuba abaningi abaneParkinson benomuzwa wokuthi lokhu kubungozi kuwuzuzisa inzuzo ekuthuthukiseni ubuchopho obujulile. kungase kungabi lula ukuthi kubhekwe ingozi efanele kulabo abane-Alzheimer's disease.
Ukucabangela ukuziphatha
Nakuba sekuye kwaba nezifundo eziningi ezenziwa ngabantu, abanye abacwaningi bacela izifundo ezengeziwe futhi zandisiwe zisebenzisa i-DBS ezilwaneni ngaphambi kokuqhubeka nokucwaninga okwengeziwe nabantu. Batshela ukuthi nakuba sekukhona abathintekayo abacwaningi be-DBS abaye babhekana nokuthuthukiswa kwengqondo, kuye kwaba nabanye abambalwa abenqabe ezindaweni ezithile zokucabangela emva kokukhushulwa kobuchopho obujulile.
Laba baphandi baphinde baqokomise ukuthi kukhona ukungabi nokuqonda kokuthi ukukhushulwa kobuchopho obujulile kusebenza kanjani; ngakho-ke, batusa ukuthi ulwazi oluningi luyatholakala ngaphambi kokwandisa izilingo zomtholampilo nabantu.
Izwi elivela
Ukukhushulwa kobuchopho obujulile kuye kwasungulwa kahle njengesifo esifanele sesifo sikaParkinson; Kodwa-ke, ucwaningo olwengeziwe luyadingeka ukuze luqaphele izinzuzo zalo ezifweni ze-Alzheimer's. Ikhono le-DBS lokuthuthukiswa kwengqondo lithandeka, ikakhulukazi njengoba siqhubeka silwela ukuthola ukwelashwa okuphumelelayo kwe-Alzheimer's.
> Imithombo:
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> Hescham S, Temel Y, Schipper S. et al, Fornix ukukhushulwa kobuchopho obujulile kwenza ukuba inkumbulo yesikhashana yesikhathi eside ilandelwe i-hippocampal neurogenesis. Ukwakhiwa kobuchopho nokusebenza. 2017 Mar; 222 (2): 1069-1075.
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