Studies on mechanisms underlying lasting effects of rTMS in monkeys

用正电子发射断层扫描(PET)技术记录了5只猕猴在2000脉冲、5 Hz双相脉冲rTMS治疗前后的糖代谢变化和内源性多巴胺的变化。结果显示了两个主要发现。首先，大脑中的新陈代谢变化持续了至少一周，甚至可能两周(Hayashi等人，2004年)。这表明，在治疗中每周给药一次或两周一次，对患者的大脑可以产生持续的影响。另一个发现是rTMS在基底节引起多巴胺的释放(Ohnishi等人，2004年)。这表明rTMS可能对某些类型的运动障碍患者的治疗是有效的。对人体rTMS的机制的研究在通过DLPFC进行rTMS期间的PET测量表明，它激活了腹侧纹状体(Ohnishi等人，在出版社)。这意味着DLPFC上的rTMS对于精神疾病的治疗一定是有用的。我们还研究了脑血…使用近红外光谱记录(NIR)，磁线圈下的更多流量(CBF)变化。结果表明，TMS激活引起的CBF变化模式不同于生理激活或去激活(Mochizuki等人，在出版社)。这为我们提供了有用的信息来阐明哪种刺激方法最有效地产生强大的、持久的效果。rTMS治疗运动皮质上的疼痛rTMS降低了人工注射引起的急性疼痛的程度，刺激期间的PET研究表明TMS通过改变扣带皮质的活动来减轻疼痛(Tamura et a.，2004a)。相反，同样的刺激可能会加重由特殊激光刺激器引起的慢性疼痛(Tamura等人，2004b)。这些结果表明，我们应该仔细考虑哪种刺激方法对哪种疼痛有效。单相脉冲比双相脉冲在产生持久效应方面更强大。在rTMS过程中，使用单相脉冲比使用双相脉冲时MEP增强要剧烈得多(Arai等，2005)。RTMS的持续效应在单相刺激中也比双相刺激更强。我们正在考虑一种新的刺激方法，它必须比通常的单相rTM更有效。在上述结果的基础上，我们试图阐明一种新的刺激方法，对治疗较少的人来说是最好的

PET studies in monkeysGlucose metabolic changes and endogenous dopamine changes were recorded during and after 2000 pulse, 5Hz rTMS with biphasic pulses by using positron emission tomography (PET) in five monkeys. Two main findings were shown. The first is that metabolic changes in the brain continued to be present for at least one week and probably two weeks (Hayashi et al, 2004). This indicates that we can elicit a continuous effect on the brain of patients when we give rTMS once a week or two weeks in the treatment. Another finding is that rTMS evokes dopamine release at basal ganglia (Ohnishi et al, 2004). This suggests that rTMS may be effective for thetreatment of patients with some kinds of movement disorders.Studies on mechanisms for rTMS in humansPET measurements during rTMS over DLPFC showed that it activates the ventral striatum (Ohnishi et al, in press). This means that rTMS over DLPFC must be useful for the treatment of psychiatric disorders. We also studied cerebral blood … More flow (CBF) changes under the magnetic coil using near infrared spectroscopic recordings (NIRS). The results indicate that TMS activation causes a different pattern of CBF changes from those seen in physiological activation or deactivation (Mochizuki et al, in press). This gives us useful information to elucidate which stimulation method is most effective for producing a powerful, lasting effect.rTMS treatment for painrTMS over the motor cortex reduced the degree of acute pain induced by artificial injection, and PET studies during stimulation suggested that TMS reduced the pain by changing the activity of the cingulated cortex (Tamura et a., 2004a). In contrast, the same stimulation may aggravate the chronic pain induced by a special laser stimulator (Tamura et al, 2004b). These results suggest that we should carefully consider which stimulation method is effective for which pain.Monophasic pulses are more powerful for producing a lasting effect than biphasic pulsesMEP enhancement during rTMS was much more drastic when using monophasic pulses than when using biphasic pulses (Arai et al, 2005). The lasting effect after rTMS was also more powerful in monophasic stimulation than biphasic stimulation. We are now considering a new stimulation method which must be more effective than an usual monophasic rTMS.Based on the above results, we try to elucidate a new stimulation method best for the treatment Less