Walsh V, Rushworth M
Department of Experimental Psychology, University of Oxford, UK.
Neuropsychologia. 1999 Feb;37(2):125-35.
Transcranial magnetic stimulation (TMS) offers the neuropsychologist a 'virtual lesion' method of investigating the effects of cortical dysfunction. Classical neuropsychology relies on patients with irreversible, and often diffuse brain lesions and these factors place limitations on the inferences that can be drawn about normal brain function. Thus the neuropsychologist is constrained by the extent to which the damaged brain undergoes reorganisation and by the inability to address questions regarding the timing of cognitive functions. TMS can disrupt cognitive functions for a few tens of milliseconds (although some effects of TMS can be seen for longer), with spatial resolution in the order of a centimetre and therefore allows one to study the role of brain areas without the masking effects of cortical reorganisation. The spatial and temporal resolutions are not unique to TMS but because TMS can be used as a temporary interference technique, it has a functional resolution with which one can address questions beyond the range of other neuroimaging and patient studies. Here we outline how TMS produces transitory 'lesion' effects, examine how the effects of stimulation spread in depth and breadth across the cortex and discuss the principles of the use of TMS in neuropsychology. Finally, we also itemise some issues of safety.
经颅磁刺激(TMS)为神经心理学家提供了一种研究皮质功能障碍影响的“虚拟损伤”方法。传统神经心理学依赖于患有不可逆且往往是弥漫性脑损伤的患者,而这些因素限制了我们对正常脑功能得出的推论。因此,神经心理学家受到受损大脑重组程度以及无法解决有关认知功能时间问题的能力的限制。TMS能够在几十毫秒内干扰认知功能(尽管TMS的某些效应可持续更长时间),空间分辨率约为一厘米,因此可以让人在没有皮质重组掩盖效应的情况下研究脑区的作用。空间和时间分辨率并非TMS所独有,但由于TMS可以用作一种临时干扰技术,它具有一种功能分辨率,借此可以解决其他神经成像和患者研究范围之外的问题。本文将阐述TMS如何产生短暂的“损伤”效应,探讨刺激效应如何在皮质的深度和广度上扩散,并讨论TMS在神经心理学中的使用原则。最后,我们还列举了一些安全问题。