NONINVASIVE STIMULATION OF HUMAN CENTRAL NERVOUS SYSTEM

我们继续改进运动皮质的地形图绘制技术。 采用经颅磁刺激(TMS)。我们发现机动地图 通过获得技能和运动学习来放大，揭示角色 初级运动皮质在这些认知过程中的作用。培训以达到 改变执行两个马达动作的时间可以增强他们的 皮质运动表征导致更大的重叠和 这表明时机是大脑皮层可塑性的强大触发因素。病人 皮质卒中患者(已康复)有较大的运动图 以身体受影响侧为目标的输出，并降低以下阈值 激动人心。 肌张力障碍患者皮质运动兴奋性增加及运动图谱 在肌张力障碍的对侧半球，输出是错乱的。 Side，一种可以解释运动活动溢出的机制 这些病人。磁刺激而不是电刺激重置姿势 帕金森氏病的震颤和特发性震颤提示 皮质内结构在其产生中的重要作用。 运动后MEP的促进作用(PEF)在运动后降低 慢性疲劳患者的抑郁(PED)不受影响 综合症和抑郁症。 重复性经颅磁刺激(RTMS) 辅助运动区(SMA)引起复杂运动的干扰 通过主电机传输的潜伏期比rTMS更长的序列 大脑皮层，提示中线结构在晚期 计划和执行复杂的运动动作。我们的研究还表明 SMA在节段性反射(H反射)调节中的作用。我们 发现这只手可能有两个同侧的皮质代表， 其中一个在刺激时会产生静默期，而另一个则会产生静默期 相同刺激强度下的运动诱发电位。 言语回忆在左侧颞骨中部和左侧后持续减弱。 双侧背侧-正侧rtms。将rTMS送至右侧 前额叶区域产生情绪提升和TRH分泌增加 在正常受试者和难治性脑出血患者的临床改善 抑郁症。

We continued improving techniques for topographic mapping of motor cortex using transcranial magnetic stimulation (TMS). We found that motor maps enlarge with acquisition of skills and motor learning, unveiling the role of the primary motor cortex in these cognitive processes. Training to change the timing of execution of two motor acts can enhance their cortical motor representations leading to greater overlapping and suggesting timing is a powerful trigger of cortical plasticity. Patients with cortical strokes (who have recovered) have larger maps of motor output targeting the affected side of the body and lower thresholds for excitation. Cortical motor excitability is increased in dystonia and maps of motor outputs are deranged in the hemisphere contralateral to the dystonic side, a mechanism that could explain the overflow of motor activity in these patients. Magnetic but not electrical stimulation reset postural tremor in Parkinson's disease and essential tremor suggesting an important role of intracortical structures in their generation. Post~exercise facilitation (PEF) of MEPs is decreased while postexercise depression (PED) is not affected in patients with chronic fatigue syndrome and depression. Repetitive transcranial magnetic stimulation (rTMS) delivered over the supplementary motor area (SMA) induces disruption of complex motor sequences with a longer latency than rTMS delivered over primary motor cortex, suggesting an important role for midline structures in advanced planning and performance of complex motor acts. Our studies also suggest a role of the SMA in modulation of segmental reflexes (H-reflexes). We found that the hand may have two ipsilateral cortical representations, one of which, upon stimulation, produces silent periods and the other motor evoked potentials at the same stimulus intensity. Verbal recall was consistently diminished after left midtemporal and bilateral dorsofrontal rTMS. rTMS delivered to the right lateral prefrontal area produces mood elevation and increases in TRH secretion in normal subjects and clinical improvement in patients with refractory depression.