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DOI: 10.1055/s-2008-1038197
Moderne neurophysiologische Therapiestrategien zur Behandlung motorischer Handfunktionsstörungen nach Schlaganfall
Modern Neurophysiological Strategies in the Rehabilitation of Impaired Hand Function Following StrokePublikationsverlauf
Publikationsdatum:
29. Mai 2008 (online)

Zusammenfassung
Mit modernen neurophysiologischen Stimulationstechniken, wie der repetitiven transkraniellen Magnetstimulation und der transkraniellen Gleichstromstimulation, kann die Erregbarkeit der Hirnrinde in Abhängigkeit von den gewählten Stimulationsparametern für mehrere Minuten reduziert (Inhibition) oder erhöht (Fazilitation) werden. Die zielgerichtete Modulation der Erregbarkeit der Hirnrinde kann plastische Änderungen innerhalb des Netzwerkes sensomotorischer Hirnrindenareale induzieren, wodurch auch pathologische Anpassungsprozesse, zum Beispiel infolge eines Schlaganfalls, positiv beeinflusst werden können. Die therapeutische Anwendung transkranieller hirnstimulierender Verfahren gründet sich im Wesentlichen auf die Hypothese der interhemisphärischen Kompetition. Die Arbeit gibt einen Überblick über die Anwendung von repetitiver transkranieller Magnetstimulation und transkranieller Gleichstromstimulation in der Behandlung von Handfunktionsstörungen nach Schlaganfall.
Abstract
Modern neurophysiological brain stimulation techniques, such as transcranial magnetic stimulation and direct current stimulation, are powerful tools to inhibit or facilitate cortical excitability for several minutes after stimulation depending on the stimulation parameters used. Purposeful modulation of cortical excitability may induce plastic changes within the cortical network of sensorimotor areas, and has the power to improve the function of the affected hand after stroke. The therapeutic use of transcranial brain stimulation techniques is based on the concept of interhemispheric competition. Here we give an overview of the use of repetitive transcranial magnetic stimulation and direct current stimulation in the rehabilitation of impaired hand function after stroke.
Schlüsselwörter
Zerebrale Ischämie - repetitive transkranielle Magnetstimulation - kortikale Gleichstromstimulation - Konzept der interhemisphärischen Kompetition
Key words
stroke - repetitive transcranial magnetic stimulation - transcranial direct current stimulation - interhemispheric competition
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1 Der Begriff Schlaganfall umfasst ätiologisch sowohl die zerebrale Ischämie als auch die intrazerebrale Blutung. Im Folgenden wird der Begriff Schlaganfall stellvertretend für die zerebrale Ischämie verwendet.
Priv-Doz. Dr. Dennis A. Nowak
Neurologische Klinik und Poliklinik, Klinikum der Universität zu Köln
Kerpener Straße 62
50924 Köln
eMail: dennis.nowak@uk-koeln.de