2016 年 33 巻 2 号 p. 228-233
Repetitive transcranial magnetic stimulation (rTMS) has the potentials to change brain excitability, inducing plasticity. In recent years, the use of rTMS has been increased for basic research and clinical applications, such as post–stroke complicatons, including hemiparesis, aphasia or unilateral spatial neglect.
rTMS is classified into inhibitory low–frequency (≦1Hz) and facilitatory high–frequency rTMS (≧5Hz), totally named as conventional rTMS (c–rTMS), in which stimulation pattern is regular. In contrast, patterned rTMS (p–rTMS) has irregularly modified stimulation pattern. The after–effect of rTMS, lasting beyond stimulation time, depends on the number, intensity and frequency of stimulation pulses, contributing to clinical efficacy of rTMS. Lastly, p–rTMS is used much often than c–rTMS, because the after–effect of the former is more than the latter in duration and magnitude of the effect. The author and collegue use theta burst stimulation (TBS) (Huang et al, 2005) among various p–rTMS. TBS is classified into inhibitory continuous TBS (cTBS) and facilitatory intermittent TBS (iTBS). In this report, in addition to c–rTMS, the efficacies of cTBS are described for unilateral spatial neglect (USN) or non–fluent aphasia, stimulating over posterior parietal cortex or Brodmann area 45 (BA45) on unaffected hemisphere, respectively. Also, in recent, we have reported the effect for post–stroke ataxia of hybrid therapy of iTBS over the motor cortex on affected hemisphere combined with integrated volitional control electrical stimulation (IVES).
rTMS (in particular, TBS) is expected a promising useful therapy for rehabilitation.
