Sham Transcranial Magnetic Stimulation Using Electrical Stimulation of the Scalp.
Sham Transcranial Magnetic Stimulation Using Electrical Stimulation of the Scalp.
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DOI：
10.1016/j.brs.2009.02.002
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发表时间：
2009-07-01
影响因子：
7.7
通讯作者：
Dornhoffer, John L.
中科院分区：
文献类型：
--
作者：
Mennemeier, Mark S.;Triggs, William J.;Chelette, Kenneth C.;Woods, A. J.;Kimbrell, Timothy A.;Dornhoffer, John L.
大多数伪重复经颅磁刺激（rTMS）方法在没有显著磁场的情况下无法复制主动刺激的外观、声音和感觉。开发并验证适用于受试者交叉的双盲、安慰剂对照研究的假rTMS新方法。使用匹配的空冷假TMS线圈复制主动rTMS的外观和声音。使用放置在选定肌肉上的大橡胶电极复制与rTMS相关的头皮肌肉刺激。在一个正常受试者样本中开发了与1 Hz rTMS相匹配的电刺激强度和脉冲宽度。假手术技术在与活性rTMS的背靠背比较中得到了验证，这些rTMS是在未经治疗或经历过rTMS的正常受试者的新样本中进行的。未经TMS治疗的受试者无法分辨哪种类型的刺激是主动的还是假的，或者哪种是电的还是磁的。当被迫选择时，天真的受试者错误地选择了假刺激作为活动刺激，因为电刺激比磁刺激感觉更集中。经历TMS的受试者可以正确识别假刺激和主动刺激。实验者可以发现不同条件下的细微差别。这种假rTMS方法密切模仿1Hz主动刺激的外观、声音和感觉，而不会产生明显的磁场。适用于初治受试者和交叉研究。它可以适应不同刺激部位头皮肌肉募集的差异，并且可能用于更高频率的刺激。
Most methods of sham, repetitive transcranial magnetic stimulation (rTMS) fail to replicate the look, sound, and feel of active stimulation in the absence of a significant magnetic field. To develop and validate a new method of sham rTMS appropriate for a double-blind, placebo-controlled study with subject crossover. The look and sound of active rTMS was replicated using a matched, air-cooled sham TMS coil. Scalp muscle stimulation associated with rTMS was replicated using large rubber electrodes placed over selected muscles. The intensity and pulse width of electrical stimulation necessary to match 1-Hz rTMS was developed in one sample of normal subjects. The sham technique was validated in back-to-back comparisons with active rTMS in new samples of normal subjects who were either naïve or experienced with rTMS. Subjects naïve to TMS could not tell which type of stimulation was active or sham or which was electrical or magnetic. Naïve subjects incorrectly picked sham stimulation as active, when forced to choose, because electrical stimulation felt more focused than magnetic stimulation. Subjects experienced with TMS could correctly identify sham and active stimulation. Experimenters could detect subtle differences between conditions. This method of sham rTMS closely mimics the look, sound, and feel of active stimulation at 1Hz without creating a significant magnetic field. It is valid for use with naïve subjects and in crossover studies. It can accommodate differences in scalp muscle recruitment at different sites of stimulation, and it could potentially be used with higher frequency stimulation.
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