Шум нейронной активности зрительной системы как характерная особенность и мишень для лечения амблиопии

Сегодня значительное внимание уделяется изучению клинической эффективности новых методов лечения амблиопии, таких как ТМС и tDCS, а также перцептивной и дихоптической зрительной тренировки в видеоиграх, в том числе с помощью виртуальной и дополненной реальности, целью которых является улучшение бинокулярного зрения и уменьшение межглазного подавления. Недавние достижения нейронаук позволяют по-новому взглянуть на механизмы терапевтического воздействия и определить направление новых исследований в этой области. В частности, исследования шума вызванной и спонтанной нейронной активности расширяют знания о функционировании зрительной системы при амблиопии. Фоновая нейронная активность в норме обладает сложными, самоподобными в масштабах времени колебаниями, спектр мощности которых может быть описан 1/f-функцией. 1/f-подобный спектр мощности указывает на нелинейную, фрактальную динамику нейронной активности. При амблиопии повышается вариабельность не только вызванной, но и фоновой нейронной активности, что может негативно влиять на пластичность мозга и статистические свойства колебаний. Динамика фонового шума определяет изменчивость вызванного ответа и может влиять на пластичность мозга. Предполагается, что более высокая эффективность применяемых сегодня новых методов лечения амблиопии, чем традиционных, связана с тем, что они обучают мозг лучше выделять сигнал из шума и тем самым усиливают надежность получаемой зрительной информации. С другой стороны, показано положительное влияние фрактальной фотостимуляции на вызванную биоэлектрическую активность сетчатки и зрительные характеристики пациентов с различными заболеваниями сетчатки, которые могут быть связаны с нормализацией статистических характеристик нейронного шума зрительной системы, как зависящего от стимула (вызванных зрительных ответов), так и фонового шума спонтанной активности нейронов в состоянии покоя. Можно предположить, что развитие новых фармакологических и немедикаментозных методов модуляции нейропластичности будет способствовать восстановлению структуры и функции нейронных сетей и зрительной реабилитации пациентов с амблиопией.

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