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Transkranielle magnetische Stimulation

  • Chapter
Evozierte Potentiale in Klinik und Praxis

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Zusammenfassung

Merton u. Morton hatten 1980 gezeigt, daß der menschliche Kortex transkraniell elektrisch gereizt werden kann [36]. Der Stimulus muß aber, um die kapazitiven Widerstände von Kalotte und Menin-gen zu überwinden, relativ stark sein. Deshalb wird er oft als schmerzhaft empfunden. Barker et al. stellten 1985 [3, 4] eine neue magnetische Reiztechnik vor, bei der ein sich rasch änderndes magnetisches Feld intrakraniell einen Reizstrom induziert. Dieser Strom braucht keine anderen Strukturen zu überwinden, um den Kortex zu erreichen. Bei elektrischer Stimulation verlaufen die Stromlinien zwischen den beiden extrakraniell gelegenen Reizpolen, wo sie ihre höchste Dichte haben. Der magnetisch induzierte Reizstrom hat seine höchste Dichte unter den Windungen der zirkulären Flachspule. Er wird nicht durch die Widerstände der Schädelkalotte und der Dura abgeschwächt. Das Risiko einer möglichen Fokussierung der Stromdichte im Hirngewebe durch darüberliegende Areale mit niedrigem Widerstand besteht bei magnetischer Induktion nicht [1]. Der Reiz ist schmerzlos. Von der elektrischen transkraniellen Stimulation ist bekannt, daß bipolare Elektrodenanordnung auf der Kalotte mit einer frontalen Kathode und Anode über dem Motorkortex am wirksamsten ist.

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Literatur

  1. Agnew WF, McCreery DB (1987) Considerations for safety in the use of extracranial stimulation for motor evoked potentials. Neurosurgery 20: 143–147

    Article  PubMed  CAS  Google Scholar 

  2. Barker AT, Freeston IL, Jalinous R, Jarrett JA (1986) Clinical evaluation of conduction time measurements in central motor pathways using magnetic stimulation of the human brain. Lancet I: 1325–1326

    Article  Google Scholar 

  3. Barker AT, Freeston IL, Jalinous R, Merton PA, Morton HB (1985) Magnetic stimulation of the human brain. J Physiol (Lond) 369: 3P

    Google Scholar 

  4. Barker AT, Jalinous R (1985) Non-invasive magnetic stimulation of human motor cortex. Lancet II: 1106–1107

    Article  Google Scholar 

  5. Benecke R, Meyer BU, Schönle B, Conrad B (1987) Muskelantworten im Hirnnervenbereich nach transkranieller Magnetreizung. 32. Jahrestagung Deutsche EEG-Gesellschaft, Ludwigshafen 1987

    Google Scholar 

  6. Berardelli A, Inghilleri M, Formisano R, Accornero N, Manfredi M (1987) Stimulation of motor tracts in motor neuron disease. J Neurol Neurosurg Psychiatry 50: 732–737

    Article  PubMed  CAS  Google Scholar 

  7. Berardelli A, Inghilleri M, Manfredi M, Zamponi A, Cecconi V, Dolce G (1987) Cortical and cervical stimulation after hemispheric infarction. J Neurol Neurosurg Psychiatry 50: 861–865

    Article  PubMed  CAS  Google Scholar 

  8. Bötzel K, Witt TN (1993) Transcranial cortical stimulation in syringomyelia: correlation with disability? Muscle Nerve 16: 537–541

    Article  PubMed  Google Scholar 

  9. Boyd SG, Rothwell JC, Cowan JMA, Webb PJ, Morley T, Asselman P, Marsden CD (1986) A method of monitoring function in corticospinal pathways during scoliosis surgery with a note on motor conduction velocities. J Neurol Neurosurg Psychiatry 49: 251–257

    Article  PubMed  CAS  Google Scholar 

  10. Buchthal F, Behse F (1977) Peroneal muscular atrophy (PMA) and related disorders. I. Clinical manifestations as related to biopsy findings, nerve conduction and electromyography. Brain 100: 41–66

    Article  PubMed  Google Scholar 

  11. Claus D (1989) Die transkranielle motorische Stimulation. G Fischer, Stuttgart

    Google Scholar 

  12. Claus D (1990) Central motor conduction: method and normal results. Muscle Nerve 13: 1125–1132

    Article  PubMed  CAS  Google Scholar 

  13. Claus D, Waddy HM, Harding AE, Murray NMF, Thomas PK (1990) Central motor conduction in peroneal muscular atrophy and related disorders. Ann Neurol 28: 43–49

    Article  PubMed  CAS  Google Scholar 

  14. Claus D, Harding AE, Hess CW, Mills KR, Murray NMF, Thomas PK (1988) Central motor conduction in degenerative ataxic disorders. A magnetic stimulation study. J Neurol Neurosurg Psychiatry 51: 790–795

    Article  PubMed  CAS  Google Scholar 

  15. Claus D, Mills KR, Murray NMF (1988) The influence of vibration on the response to transcranial stimulation of relaxed and voluntarily activated human muscle. J Physiol (Lond) 398: 44 (P)

    Google Scholar 

  16. Claus D, Mills KR, Murray NMM (1988) The influence of vibration on the excitability of alpha motoneurones. Electroenceph Clin Neurophysiol 69: 431–436

    Article  PubMed  CAS  Google Scholar 

  17. Claus D, Mills KR, Murray NMM (1988) Facilitation of muscle responses to magnetic brain stimulation by mechanical stimuli in man. Exp Brain Res 71: 273–278

    Article  PubMed  CAS  Google Scholar 

  18. Claus D, Spitzer A (1991) Magnetische Stimulation mit Doppelspulen - Methodik und Normalbefunde Z EEG EMG 22: 21–27

    CAS  Google Scholar 

  19. Claus D, Schubert M (1995) Magnetstimulation - Aktueller Stand in Klinik und Forschung. In: Eiger CE, Dengler R (Hrsg) Jahrbuch der Neurologie. Biermann, Zülpich, S 37–47

    Google Scholar 

  20. Claus D, Brunhölzl C, Kerling FP, Henschel S (1995) Transcranial magnetic stimulation as a diagnostic and prognostic test in amyotrophic lateral sclerosis. J Neurol Sci 129 (Suppl): 30–34

    Article  PubMed  Google Scholar 

  21. Claus D, Kerling F, Förster A (im Druck) Zervikale Myelopathie, Neurophysiologische Untersuchungen zur Prognose. In: Huffmann G, Braune HJ, Griewig B (Hrsg) Zerebrale und spinale Prozesse. Einhorn, Reinbek

    Google Scholar 

  22. Cruz Martinez A, Arpa J, Alonso M, Palomo F, Villoslada C (1995) Transcranial magnetic stimulation in multiple system and late onset cerebellar atrophies. Acta Neurol Scand 92: 218–224

    Google Scholar 

  23. Day BL, Thompson PD, Dick JP, Nakashima K, Marsden CD (1987) Different sites of action of electrical and magnetic stimulation of the human brain. Neurosci Lett 75: 101–106

    Article  PubMed  CAS  Google Scholar 

  24. Dyck JP, Lambert EH (1968) Lower motor and primary sensory neuron diseases with peroneal muscular atrophy. II. Neurologic, genetic and electrophysiologic findings in various neuronal degenerations. Arch Neurol 18: 619–625

    Article  PubMed  CAS  Google Scholar 

  25. Felix D, Wiesendanger M (1971) Pyramidal and non-pyramidal motor cortical effects on distal forelimb muscles of monkeys. Exp Brain Res 12: 81–91

    Article  PubMed  CAS  Google Scholar 

  26. Harding AE (1981) Early onset cerebellar ataxia with retained reflexes. A clinical and genetic study of a disorder distinct from Friedreich’s ataxia. J Neurol Neurosurg Psychiatry 44: 503–508

    Article  PubMed  CAS  Google Scholar 

  27. Harding AE (1981) Hereditary „pure“ spastic paraplegia: A clinical and genetic study of 22 families. J Neurol Neurosurg Psychiatry 44: 871–883

    Article  PubMed  CAS  Google Scholar 

  28. Harding AE (1983) Classification of the hereditary ataxias and paraplegias. Lancet I: 1151–1155

    Article  Google Scholar 

  29. Harding AE (1984) The hereditary ataxias and related disorders. Churchill Livingstone, London

    Google Scholar 

  30. Harding AE, Thomas PK (1980) The clinical features of hereditary motor and sensory neuropathy types I and II. Brain 103: 259–280

    Article  PubMed  CAS  Google Scholar 

  31. Harding AE, Thomas PK (1984) Peroneal muscular atrophy with pyramidal features. J Neurol Neurosurg Psychiatry 47: 168–172

    Article  PubMed  CAS  Google Scholar 

  32. Heald A, Bates D, Cartlidge NEF, French JM, Miller S (1993) Longitudinal study of central motor conduction time following stroke. 1. Natural history of central motor conduction. Brain 116: 1355–1370

    Article  PubMed  Google Scholar 

  33. Heald A, Bates D, Cartlidge NEF, French JM, Miller S (1993) Longitudinal study of central motor conduction time following stroke. 2. Central motor conduction measured with 72 h after stroke as a predictor of functional outcome at 12 months. Brain 116: 1371–1385

    Article  PubMed  Google Scholar 

  34. Henneman E (1957) Relation between size of neurons and their susceptibility to discharge. Science 126: 1345–1347

    Article  PubMed  CAS  Google Scholar 

  35. Hess CW, Mills KR, Murray NMF (1986) Measurement of central motor conduction in multiple sclerosis by magnetic brain stimulation. Lancet 16: 355–358

    Article  Google Scholar 

  36. Hess CW, Mills KR, Murray NMF (1986) Magnetic stimulation of the human brain: Facilitation of motor responses by voluntary contraction of ipsilateral and contralateral muscles with additional observation on an amputee. Neurosci Lett 71: 235–240

    Article  PubMed  CAS  Google Scholar 

  37. Hess CW, Mills KR, Murray NMF (1986) Magnetic stimulation of the human brain: The effects of voluntary muscle activity. J Physiol (Lond) 378: 37P

    Google Scholar 

  38. Hess CW, Mills KR, Murray NMF (1987) Central motor conduction in hereditary motor and sensory neuropathy (HMSN). Electroenceph Clin Neurophysiol 66: 46

    Google Scholar 

  39. Hess CW, Mills KR, Murray NMF (1987) Responses in small hand muscles from magnetic stimulation of the human brain. J Physiol (Lund) 388: 397–419

    CAS  Google Scholar 

  40. Hess CW, Mills KR, Murray NMF, Schriefer TN (1987) Magnetic brain stimulation: Central motor conduction studies in multiple sclerosis. Ann Neurol 22: 744–752

    Article  PubMed  CAS  Google Scholar 

  41. Holmes GL, Shaywitz BA (1977) Strumpell’s pure familial spastic paraplegia: Case study and review of the literature. J Neurol Neurosurg Psychiatry 40: 1003–1008

    Article  PubMed  CAS  Google Scholar 

  42. Ingram DA, Swash M (1987) Central motor conduction is abnormal in motor neuron disease. J Neurol Neurosurg Psychiatry 50: 159–166

    Article  PubMed  CAS  Google Scholar 

  43. Landgren S, Phillips CG, Porter R (1962) Minimal synaptic actions of pyramidal impulses on some alpha motoneurones of the baboon’s hand and forearm. J Physiol (Lond) 161: 91–111

    CAS  Google Scholar 

  44. Landgren S, Phillips CG, Porter R (1962) Cortical fields of origin of themonosynaptic pyramidal pathways to some alpha motoneurones of the baboon’s hand and forearm. J Physiol (Lond) 161: 112–125

    CAS  Google Scholar 

  45. Maertens de Noordhout A, Remade J, Pepin J, Born J, Dellwaide P (1991) Magnetic stimulation of the motor cortex in cervical spondylosis. Neurology 41: 75–80

    Article  PubMed  CAS  Google Scholar 

  46. Masur H, Elger C, Render K, Fahrendorf G, Ludolph A (1989) Functional deficits of central sensory and motor pathways in patients with cervical spinal stenosis: a study of SEPs and EMG responses to non-invasive brain stimulation. Electroencephal Clin Neurophysiol 74: 450–457

    Article  CAS  Google Scholar 

  47. Masur H, Oberwittler C, Fahrendorf G et al. (1992) The relation between functional deficits, motor and sensory conduction times and MRI findings in syringomyelia. Electroencephal Clin Neurophysiol 85: 321–330

    Article  CAS  Google Scholar 

  48. Matsuda H, Funakoshi K, Nakamura A, Shimazu A (1987) Descending evoked spinal cord potential elicited by stimulating the motor cortex through the skull - intraoperative electrodiagnosis and monitoring. Electroenceph Clin Neurophysiol 66: S65

    Google Scholar 

  49. Merton PA, Morton HB (1980) Stimulation of the cerebral cortex in the intact human subject. Nature 285: 227

    Article  PubMed  CAS  Google Scholar 

  50. Merton PA, Morton HB (1986) A magnetic stimulator for the human motor cortex. J Physiol (Lond) 381: 10 P

    Google Scholar 

  51. Mills KR, Murray NMF (1985) Corticospinal tract conduction time in multiple sclerosis. Ann Neurol 18: 601–605

    Article  PubMed  CAS  Google Scholar 

  52. Mills KR, Murray NMF (1986) Electrical stimulation over the human vertrebral column: Which neural elements are excited? Electroenceph Clin Neurophysiol 63: 582–589

    Article  PubMed  CAS  Google Scholar 

  53. Mills KR, Murray NMF (1986) Neurophysiological evaluation of associated demyelinating peripheral neuropathy and multiple sclerosis: A case report. J Neurol Neurosurg Psychiatry 49: 320–323

    Article  PubMed  CAS  Google Scholar 

  54. Mills KR, Murray NMF, Hess CW (1987) Magnetic and electrical transcranial brain stimulation: Physiological mechanisms and clinical applications. Neurosurgery 20: 164–168

    Article  PubMed  CAS  Google Scholar 

  55. Nogues M, Pardal A, Merello M, Miguel M (1992) SEPs and CNS magnetic stimulation in syringomyelia. Muscle Nerve 15: 993–1001

    Article  PubMed  CAS  Google Scholar 

  56. Patton HD, Amassian VE (1954) Single-and multiple-unit analysis of cortical stage of pyramidal tract activation. J Neurophysiol 17: 345–363

    PubMed  CAS  Google Scholar 

  57. Pelosi L, Caruso G, Baldi P, Milano C, Paolino G, Lotti G (1987) Motor evoked potentials to transcranial electrical stimulation in man: Intraoperative recordings along the spinal cord. Electroenceph Clin Neurophysiol 66: S 79

    Google Scholar 

  58. Robinson L, Little J (1990) Motor-evoked potentials reflect spinal cord func-tion in post-traumatic syringomyelia. Am J Phys Med Rehab 69: 307–310

    Article  CAS  Google Scholar 

  59. Rossini PM, Caramia MD, Zarola F (1987) Mechanisms of nervous propagation along central motor pathways: Noninvasive evaluation in healthy subjects and in patients with neurological disease. Neurosurgery 20: 183–191

    Article  PubMed  CAS  Google Scholar 

  60. Schriefer TN, Hess CW, Mills KR, Murray NMF (1989) Central motor conduction studies in motor neurone disease using magnetic brain stimulation. Electroenceph Clin Neurophysiol 74: 431–437

    Article  PubMed  CAS  Google Scholar 

  61. Schriefer TN, Mills KR, Murray NMF, Hess CW (1988) Evaluation of proximal facial nerve conduction by transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry 51: 60–66

    Article  PubMed  CAS  Google Scholar 

  62. Schut JW (1950) Hereditary ataxia: Clinical study through six generations. Arch Neurol Psychiatry 63: 535–568

    Google Scholar 

  63. Snooks J, Swash M (1985) Motor conduction velocity in the human spinal cord: Slowed conduction in multiple sclerosis and radiation myelopathy. J Neurol Neurosurg Psychiatry 48: 1135–1139

    Article  PubMed  CAS  Google Scholar 

  64. Sobue G, Terao S, Kachi T, Ken E, Hashizume Y, Mitsuma T, Takahashi A (1992) Somatic motor efferents in multiple system atrophy with autonomic failure: a clinico-pathological study. J Neurol Sci 112: 113–125

    Article  PubMed  CAS  Google Scholar 

  65. Strümpell A (1880) Beiträge zur Pathologie des Rückenmarks. Arch Psychiatr Nervenkr 10: 676–717

    Article  Google Scholar 

  66. Symonds CP, Blackwood W (1962) Spinal cord compression in hypertrophic neuritis. Brain 85: 251–260

    Article  Google Scholar 

  67. Thomas PK, Walker RWH, Budge P et al. (1987) Chronic demyelinating peripheral neuropathy associated with multifocal central nervous system demyelination. Brain 110: 53–76

    Article  PubMed  Google Scholar 

  68. Thompson PD, Day BL, Bothwell JC et al. (1987) The interpretation of electromyographic responses to electrical stimulation of the motor cortex in diseases of the upper motor neurone. J Neurol Sci 80: 91–110

    Article  PubMed  CAS  Google Scholar 

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  1. D. Claus
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Editors and Affiliations

  1. Universität Witten/Herdecke, Klinikum Wuppertal, Heusnerstraße 40, 42283, Wuppertal, Germany

    Johannes Jörg (Direktor der Neurologischen Klinik) (Direktor der Neurologischen Klinik)

  2. Evangelischen Krankenhauses Gelsenkirchen, Munckelstraße 27, 45879, Gelsenkirchen, Germany

    Horst Hielscher (Chefarzt der Neurologischen Klinik) (Chefarzt der Neurologischen Klinik)

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© 1997 Springer-Verlag Berlin Heidelberg

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Claus, D. (1997). Transkranielle magnetische Stimulation. In: Jörg, J., Hielscher, H. (eds) Evozierte Potentiale in Klinik und Praxis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59032-0_12

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  • DOI: https://doi.org/10.1007/978-3-642-59032-0_12

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