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Nervenheilkunde 2020; 39(06): 382-389
DOI: 10.1055/a-1124-0007
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

Transkranielle Magnetstimulation

Therapeutische Optionen in der SchmerztherapieTranscranial magnetic stimulationTherapeutic options in pain therapy
Stefan M. Golaszewski∗
1   Univ.-Klinik für Neurologie und Neuroscience-Institut, Paracelsus Medizinische Privatuniversität Salzburg, Österreich
2   Karl-Landsteiner-Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Österreich
,
Raffaele Nardone
1   Univ.-Klinik für Neurologie und Neuroscience-Institut, Paracelsus Medizinische Privatuniversität Salzburg, Österreich
2   Karl-Landsteiner-Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Österreich
3   Abteilung für Neurologie, Franz-Tappeiner-Hospital Meran, Italien
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Publication History

Publication Date:
04 June 2020 (online)

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ZUSAMMENFASSUNG

Die repetitive transkranielle Magnetstimulation ermöglicht eine nicht invasive Modulation der kortikalen Erregbarkeit des Gehirns, welche durch verschiedene Stimulationsparameter erhöht oder verringert werden kann. Die induzierten Veränderungen können vorübergehend oder längerfristig sein. Es können im Gehirn unterschiedliche neuromodulatorische Prozesse hinsichtlich der stimulierten Region und des stimulierten neuronalen Gewebes induziert werden, was die Schmerzwahrnehmung im Gehirn verändern kann. Es werden kontinuierliche Serien von TMS-Pulsen mit niedriger (≤ 1Hz) oder höherer Frequenz (> 1Hz) mit Hemmung oder Fazilitierung der kortikalen Erregbarkeit durch Veränderungen der synaptischen Transmission angewendet, was zu synaptischer Plastizität insbesondere im Bereich der Langzeitpotenzierung (LTP) oder Langzeitdepression (LTD) führt. Hinreichend Evidenz für die Wirksamkeit der rTMS in der Schmerztherapie gibt es insbesondere für chronisch neuropathische Schmerzen zentraler oder peripherer Genese und für die Fibromyalgie.

ABSTRACT

Repetitive transcranial magnetic stimulation enables non-invasive modulation of the cortical excitability of the brain, which can be increased or decreased by various stimulation parameters. The induced changes can be temporary or long-term. Different neuromodulatory processes with regard to the stimulated region and the stimulated neuronal tissue can be induced in the brain, which can modulate the sensation of pain in the brain. Continuous series of TMS pulses with low (≤ 1Hz) or higher frequency (> 1Hz) with inhibition or facilitation of cortical excitability by changes in synaptic transmission are used, which leads to synaptic plasticity especially in the domain of long-term potentiation (LTP) or long-term depression (LTD). There is acceptable evidence for the benefit of rTMS in pain therapy, particularly for chronic neuropathic pain of central or peripheral origin and for fibromyalgia.

Schlüsselwörter

rTMS - Neuromodulation - nicht invasive Hirnstimulation - synaptische Plastizität - chronischer Schmerz

Key words

rTMS - neuromodulation - non-invasive brain stimulation - synaptic plasticity - chronic pain
 

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