Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector81410.54101/ACEN.2022.3.9TechnologiesТехнологииReview ArticleMetaplasticity and non-invasive brain stimulation: the search for new biomarkers and directions for therapeutic neuromodulationМетапластичность и неинвазивная стимуляция мозга: поиск новых биомаркеров и направлений терапевтической нейромодуляцииhttps://orcid.org/0000-0003-0716-3737BakulinIlya S.БакулинИлья Сергеевич
Russian Federation

Cand. Sci. (Med.), researcher, Head, Non-invasive neuromo- dulation group, Institute of Neurorehabilitation

к.м.н., н.с., рук. группы неинвазивной нейромодуляции Института нейрореабилитации и восстановительных технологий

bakulinilya@gmail.comhttps://orcid.org/0000-0003-1841-1177PoydashevaAlexandra G.ПойдашеваАлександра Георгиевна
Russian Federation

junior researcher, Non-invasive neuromodulation group, Institute of Neurorehabilitation

м.н.с. группы неинвазивной нейромодуляции Института нейрореабилитации и восстановительных технологий

alexandra.poydasheva@gmail.comhttps://orcid.org/0000-0001-8544-3107ZabirovaAlfiia H.ЗабироваАльфия Ходжаевна
Russian Federation

postgraduate student, neurologist

аспирант, врач-невролог

alfijasabirowa@gmail.comhttps://orcid.org/0000-0003-3956-6362SuponevaNatalia A.СупоневаНаталья Александровна
Russian Federation

D. Sci. (Med.), Corresponding Member of RAS, Director, Institute of Neurorehabilitation

д.м.н., профессор, член-корреспондент РАН, директор Института нейрореабилитации и восстановительных технологий

nasu2709@mail.ruhttps://orcid.org/0000-0002-6338-0392PiradovMichael A.ПирадовМихаил Александрович
Russian Federation

D. Sci. (Med.), Professor, Academician of RAS, Director

д.м.н., профессор, академик РАН, директор

Mpi711@gmail.comResearch Center of NeurologyФГБНУ «Научный центр неврологии»1010202216374822401202215022022Copyright ©; 2022, Bakulin I.S., Poydasheva A.G., Zabirova A.H., Suponeva N.A., Piradov M.A.Copyright ©; 2022, Бакулин И.С., Пойдашева А.Г., Забирова А.Х., Супонева Н.А., Пирадов М.А.2022Bakulin I.S., Poydasheva A.G., Zabirova A.H., Suponeva N.A., Piradov M.A.Бакулин И.С., Пойдашева А.Г., Забирова А.Х., Супонева Н.А., Пирадов М.А.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/814

Metaplasticity (plasticity of synaptic plasticity) is defined as a change in the direction or degree of synaptic plasticity in response to preceding neuronal activity. Recent advances in brain stimulation methods have enabled us to non-invasively examine cortical metaplasticity, including research in a clinical setting. According to current knowledge, non-invasive neuromodulation affects synaptic plasticity by inducing cortical processes that are similar to long-term potentiation and depression. Two stimulation blocks are usually used to assess metaplasticity — priming and testing blocks. The technology of studying metaplasticity involves assessing the influence of priming on the testing protocol effect.

Several dozen studies have examined the effects of different stimulation protocols in healthy persons. They found that priming can both enhance and weaken, or even change the direction of the testing protocol effect. The interaction between priming and testing stimulation depends on many factors: the direction of their effect, duration of the stimulation blocks, and the interval between them.

Non-invasive brain stimulation can be used to assess aberrant metaplasticity in nervous system diseases, in order to develop new biomarkers. Metaplasticity disorders are found in focal hand dystonia, migraine with aura, multiple sclerosis, chronic disorders of consciousness, and age-related cognitive changes.

The development of new, metaplasticity-based, optimized, combined stimulation protocols appears to be highly promising for use in therapeutic neuromodulation in clinical practice.

Метапластичность (пластичность синаптической пластичности) определяется как изменение направленности или выраженности синаптической пластичности в ответ на предшествующую нейрональную активность. Активное развитие в последние годы методов стимуляции мозга позволяет изучать метапластичность коры неинвазивно, в том числе в клинических условиях. Согласно современным представлениям, эффект неинвазивной нейромодуляции основан на её влиянии на синаптическую пластичность за счёт индукции в коре процессов, сходных с долговременной потенциацией и депрессией. Для оценки метапластичности обычно используются 2 блока стимуляции — прайминговый и тестовый. Суть технологии изучения метапластичности состоит в оценке влияния прайминга на эффект тестового протокола.

В нескольких десятках исследований изучены эффекты различных комбинаций протоколов стимуляции у здоровых лиц, при этом показано, что прайминг может как усиливать, так и ослаблять или даже менять направленность эффекта тестового протокола. Особенности взаимодействия прайминговой и тестовой стимуляции зависят от многих факторов: направленности их эффекта, продолжительности блоков стимуляции и интервала между ними.

Неинвазивная стимуляция мозга может использоваться для оценки аберрантной метапластичности при заболеваниях нервной системы с целью разработки новых биомаркеров. Нарушения метапластичности выявляются при писчем спазме, мигрени с аурой, рассеянном склерозе, хронических нарушениях сознания и возрастных когнитивных нарушениях.

Большие перспективы связаны с разработкой новых, основанных на метапластичности оптимизированных комбинированных протоколов стимуляции для использования терапевтической нейромодуляции в клинической практике.

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