Hirnstimulation in der Rehabilitation von Handfunktionsstörungen nach Schlaganfall

Zusammenfassung

Neurophysiologische Techniken zur Hirnstimulation, wie die repetitive transkranielle Magnetstimulation und die transkranielle Gleichstromstimulation, können die Erregbarkeit der Hirnrinde abhängig von den gewählten Stimulationsparametern für einen die Stimulationszeit überdauernden Zeitraum hemmen (Inhibition) oder erhöhen (Fazilitation). Die Modulation der Erregbarkeit der Hirnrinde kann plastische Änderungen im funktionellen Zusammenspiel der sensomotorischen Hirnrindenareale in beiden Hemisphären induzieren. Dadurch können auch maladaptive Anpassungsprozesse infolge einer Hirnschädigung positiv beeinflusst werden. Innerhalb des Konzepts der interhemisphärischen Kompetition werden hirnstimulierende Verfahren zunehmend in der Rehabilitation von motorischen Störungen der oberen Extremität nach Schlaganfall angewendet. Die Arbeit gibt einen Überblick über die aktuelle Literatur zur Anwendung der repetitiven transkraniellen Magnetstimulation und der transkraniellen Gleichstromstimulation in der Therapie von Handfunktionsstörungen nach Schlaganfall.

Abstract

Neurophysiological techniques for brain stimulation, such as transcranial magnetic stimulation and transcranial direct current stimulation, can cause lasting inhibition or facilitation of cortical excitability. The modulation of cortical excitability may induce plastic functional changes within the cortical network of sensorimotor areas of both hemispheres. The modulation of cortical excitability can also temporarily reverse maladaptive plasticity after brain damage. Within the concept of interhemispheric competition, brain stimulation techniques are increasingly applied to enhance the effectiveness of upper limb motor rehabilitation after stroke. This review provides a critical summary of the application of repetitive transcranial magnetic stimulation and transcranial direct current stimulation in the rehabilitation of impaired hand function after stroke.

Schlüsselwörter

Schlaganfall - transkranielle Gleichstromstimulation - repetitive transkranielle Magnetstimulation - interhemisphärische Kompetition

Keywords

stroke - transcranial direct current stimulation - repetitive transcranial magnetic stimulation - interhemispheric competition

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