Säisänen Laura, Julkunen Petro, Niskanen Eini, Danner Nils, Hukkanen Taina, Lohioja Tarja, Nurkkala Jouko, Mervaala Esa, Karhu Jari, Könönen Mervi
Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
J Clin Neurophysiol. 2008 Dec;25(6):367-72. doi: 10.1097/WNP.0b013e31818e7944.
Navigated transcranial magnetic stimulation (TMS) is a tool for targeted, noninvasive stimulation of cerebral cortex. Transcranial stimuli can depolarize neurons and evoke measurable effects which are unique in two ways: the effects are caused directly and without a consciousness of the subject, and, the responses from peripheral muscles provide a direct measure for the integrity of the whole motor pathway. The clinical relevance of the method has not always been fully exposed because localizing the optimal stimulation site and determining the optimal stimulation strength have been dependent on time-consuming experimentation and skill. Moreover, in many disorders it has been uncertain, whether the lack of motor responses is the result of true pathophysiological changes or merely because of unoptimal stimulation. We characterized the muscle responses from human primary motor cortex system by navigated TMS to provide normative values for the clinically relevant TMS parameters on 65 healthy volunteers aged 22 to 81 years. We delivered focal TMS pulses on the primary motor area (M1) and recorded muscle responses on thenar and anterior tibial muscles. Motor threshold, latencies and amplitudes of motor-evoked potentials, and silent period duration were measured. The correction of the motor-evoked potential latency for subjects' height is provided. In conclusion, we provide a modified baseline of TMS-related parameters for healthy subjects. Earlier such large-scale baseline material has not been available.
导航经颅磁刺激(TMS)是一种用于靶向、非侵入性刺激大脑皮层的工具。经颅刺激可使神经元去极化并引发可测量的效应,这些效应在两个方面具有独特性:效应是直接产生的,且受试者没有意识;此外,外周肌肉的反应为整个运动通路的完整性提供了直接测量方法。该方法的临床相关性并不总是能完全体现出来,因为确定最佳刺激部位和最佳刺激强度一直依赖于耗时的实验和技巧。此外,在许多疾病中,运动反应缺失是真正的病理生理变化的结果还是仅仅因为刺激不优化尚不确定。我们通过导航TMS对人类初级运动皮层系统的肌肉反应进行了特征描述,以提供65名年龄在22至81岁的健康志愿者临床相关TMS参数的标准值。我们在初级运动区(M1)施加局部TMS脉冲,并记录拇短展肌和胫前肌的肌肉反应。测量运动阈值、运动诱发电位的潜伏期和幅度以及静息期持续时间。提供了根据受试者身高对运动诱发电位潜伏期进行的校正。总之,我们为健康受试者提供了一个经修改的TMS相关参数基线。此前尚未有如此大规模的基线资料。
J Clin Neurophysiol. 2008-12
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