NONINVASIVE STIMULATION OF HUMAN CENTRAL NERVOUS SYSTEM

最近，这些技术已经可以用于非侵入性的 刺激人类大脑皮层和深部近端外周神经。 刺激可以用高电压、极短的电脉冲 或通过磁刺激。一个目的是使用这些方法来 人体大脑皮层不同部位的非侵入性定位 运动皮质、感觉皮质和语言皮质。另一个目的是 研究不同疾病状态下的皮质生理学。 我们在理解技术方面继续取得进展。 定义了最佳的方法来映射不同的 运动皮质中的身体部位表征。我们已经能够 将刺激部位与大脑激活区域进行比较 正电子发射断层扫描(PET)通过映射两者的结果 研究相同的磁共振成像扫描；相关性是 太棒了。人们已经投入了大量的努力来研究 脑刺激的抑制作用。例如，我们已经展示了， 同侧静默期似乎不是由 老茧体部。我们还研究了大脑对 成对和成串的刺激。大脑经历了复杂的反应， 刺激和抑制。长而结实的火车，癫痫患者 癫痫发作是可能发生的，我们已经制定了安全指南来 避免这种情况。我们研究了对大脑刺激的反应时间，发现 磁刺激可以加快对任何其他刺激的反应。 磁刺激还可以加快患者的反应速度 帕金森氏症，这种效应可能在治疗上有用。 后续我们先前的研究显示运动重组 前臂和手部麻醉后的皮质通路，我们 已经表明，这种效应很可能主要是在大脑皮层 水平。 关于感官效应，我们已经证明了 阻断体感的刺激不同于 负责马达的激活。我们一直在继续研究视觉 大脑皮质证明有可能产生简短的视觉图像 在盲人患者身上。这项技术可能会识别出适合于 使用直接脑刺激的视觉假体。

Recently, techniques have become available for the noninvasive stimulation of the human cortex and deep proximal peripheral nerves. Stimulation can be with a high-voltage, extremely brief electrical pulse or with magnetic stimulation. One purpose is to use these methods for noninvasive localization of different parts of the human cortex including motor cortex, sensory cortex and language cortex. Another purpose is to study cortical physiology in different disease states. We have continued to make advances in understanding the technical aspects of magnetic stimulation, defining the optimal method to map different body part representations in the motor cortex. We have been able to compare the site of stimulation with the area of the brain activated in positron emission tomography (PET) scans by mapping the results of both studies onto the same magnetic resonance imaging scan; correlation is excellent. Extensive effort has been devoted to the study of the inhibitory effects of brain stimulation. We have shown, for example, that the ipsilateral silent period does not appear to be transmitted by the corpus callosum. We have also studied the response of the brain to pairs and trains of stimuli. The brain undergoes a complex response of excitation and inhibition. With long and strong trains, epileptic seizures can be precipitated, and we have developed safety guidelines to avoid this. We have studied reaction time to brain stimulation and found that magnetic stimulation can speed the response to any other stimulus. Magnetic stimulation can also speed the responses in patients with Parkinson's disease, and this effect may be useful therapeutically. Following-up our previous studies that showed reorganization of motor cortex pathways following anesthetic block of the forearm and hand, we have shown that this effect is probably mediated largely at the cortical level. In relation to sensory effects, we have demonstrated that the sites of stimulation that block somatosensory sensation differ from those responsible for motor activation. We have continued to study the visual cortex demonstrating that it was possible to produce brief visual images in blind patients. This technique may identify patients suitable for a visual prosthesis that uses direct brain stimulation.