NONINVASIVE STIMULATION OF HUMAN CENTRAL NERVOUS SYSTEM

最近，技术已经成为可用于非侵入性 刺激人类皮层和深部近端外周神经。 刺激可以是高压的，非常短暂的电脉冲 或者用磁刺激。 一个目的是使用这些方法， 非侵入性定位人类大脑皮层的不同部分， 运动皮层、感觉皮层和语言皮层。 另一个目的是 研究不同疾病状态下的皮层生理学。 我们在技术方面的理解不断取得进展 磁刺激，定义最佳方法来映射不同的 运动皮质中的身体部位代表。 我们已经能够 将刺激的部位与大脑中被激活的区域进行比较， 正电子发射断层扫描（PET）通过映射两者的结果 研究到相同的磁共振成像扫描;相关性是 好极了 已经作出了广泛的努力来研究 脑刺激的抑制作用。 例如，我们已经证明， 同侧静默期看起来不像是由 胼胝体 我们还研究了大脑对 成对和成列的刺激。 大脑经历了一个复杂的反应， 兴奋和抑制。 有着长而强的火车，癫痫 癫痫发作可能会加速，我们已经制定了安全指南， 避免这个。 我们研究了大脑刺激的反应时间， 磁刺激可以加速对任何其他刺激的反应。 磁刺激也可以加速患者的反应， 帕金森氏病，这种效果可能是有用的治疗。 我们之前的研究表明， 皮质通路后，前臂和手的麻醉阻滞，我们 已经表明，这种影响可能主要是在皮层介导的， 水平 关于感官效果，我们已经证明， 阻断躯体感觉刺激不同于那些 负责激活运动神经 我们继续研究 大脑皮层能够产生简短的视觉图像 在盲人患者中。 该技术可以识别适合于治疗的患者。 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.