Recovery of motor function by noninvasive stimulation of the human brain.

点击翻译按钮获取中文摘要

1) We established EEG monitoring system during TMS for patients with risk of epilepsy. First, we determined the changes and responses in the electroencephalogram (EEG) induced by transcranial magnetic stimulation (TMS) of the scalp of stroke patients. To reduce stimulus artifacts, we created a circuit that blocked the input for 150 msec after stimulation. No epileptiform afterdischarges or sharp wave potentials were observed. After this preliminary study, we revised the artifact-reducing circuit so as to record EEG 50 msec after stimulation.2) We investigated facilitation in voluntary movement, and demonstrated that facilitation occurs during voluntary contraction of antagonist or other heteronymous muscles. It also was found that the degree of facilitation induced by a heteronymous muscle contraction differed between individual muscles, and between dominant and nondominant forearm muscles.3) We investigated short-term effects of TMS over the frontal lobe on cognitive function such as … More frontal lobe function, attention, and memory, and EEG of healthy subjects. Then, we concluded that TMS has no adverse effects on cognitive and electrophysiologic function.4) One stroke patient (48 years of age, male, left putaminal hemorrhage, right hemiplegia for 3 years and 4 months) provided his informed consent to participate in this study. TMS (0.1 Hz, 100 stimuli) were delivered over the motor cortex every week for 3 months. The subject was instructed to make efforts of contracting the target muscle (facilitation) when stimulated. Before stimulation the subject could flex fingers (mass flexion), and extend the little finger less than 5 degrees (Brunnstrom stage 3). After stimulation the subject could extend all the fingers and thumb except the index finger, and move the little finger separately. TMS could not evoke motor responses during the first three sessions. Motor responses evoked by TMS appeared at the 4th session, and amplitudes of the motor evoked potentials increased gradually. No epileptiform afterdischarges or sharp wave potentials were observed. In the future study effectiveness of TMS will be investigated in a rondomized control study and an indication of TMS for treatment of hemiplegia will be suggested. Less