小脳と前庭におけるneuromodulation

抄録

The vestibular system and the cerebellum contribute to postural control and ocular movements. Gaze stabilization exercise (GSE) is often conducted to improve postural balance and dynamic gaze ability. We found that GSE reduces body sway while standing upright with modulation of the vestibulospinal reflex. Additionally, the sensory contribution of the vestibular system over postural control increases after GSE. GSE increases the oculomotor range with respect to head movements, thereby improving the dynamic gaze ability. However, this modulation was absent after low-frequency repetitive transcranial magnetic stimulation over the cerebellum (crTMS). These findings indicate that GSE improves eye-head coordination, and the cerebellum contributes to this modulation. Noisy galvanic vestibular stimulation (nGVS) after crTMS modulates vestibulospinal excitability, but no modulation was observed without combining these stimuli. These findings indicate that nGVS can modulate the vestibulospinal reflex, thereby improving postural stability, and the cerebellum contributes to this modulation. The effect of single-pulse cerebellar TMS on spinal reflex excitability can be modulated by cerebellar transcranial direct current stimulation. This indicates that the cerebellum modulates spinal reflexes over postural control, and we can modify this effect by using a neuromodulation montage. In this review, we report the above findings on neuromodulation of the cerebellum and the vestibular system.