Rudolf Magnus Institute of Neuroscience, Department of Neuroscience and Pharmacology, University Medical Center Utrecht, The Netherlands.
Brain Stimul. 2010 Apr;3(2):95-118. doi: 10.1016/j.brs.2009.10.005. Epub 2009 Nov 24.
During the last two decades, transcranial magnetic stimulation (TMS) has rapidly become a valuable method to investigate noninvasively the human brain. In addition, repetitive TMS (rTMS) is able to induce changes in brain activity that last after stimulation. Therefore, rTMS has therapeutic potential in patients with neurologic and psychiatric disorders. It is, however, unclear by which mechanism rTMS induces these lasting effects on the brain. The effects of rTMS are often described as LTD- or LTP-like, because the duration of these alterations seems to implicate changes in synaptic plasticity. In this review we therefore discuss, based on rTMS experiments and knowledge about synaptic plasticity, whether the physiologic basis of rTMS-effects relates to changes in synaptic plasticity. We present seven lines of evidence that strongly suggest a link between the aftereffects induced by rTMS and the induction of synaptic plasticity. It is, nevertheless, important to realize that at present it is impossible to demonstrate a direct link between rTMS on the one hand and synaptic plasticity on the other. Therefore, we provide suggestions for future, innovating research, aiming to investigate both the local effects of rTMS on the synapse and the effects of rTMS on other, more global levels of brain organization. Only in that way can the aftereffects of rTMS on the brain be completely understood.
在过去的二十年中，经颅磁刺激（TMS）已迅速成为一种研究人类大脑的非侵入性的宝贵方法。此外，重复经颅磁刺激（rTMS）能够诱导刺激后持续的脑活动变化。因此，rTMS 在神经和精神疾病患者中具有治疗潜力。然而，rTMS 通过哪种机制诱导这些对大脑的持久影响尚不清楚。rTMS 的作用通常被描述为 LTD 或 LTP 样，因为这些改变的持续时间似乎涉及突触可塑性的变化。因此，在这篇综述中，我们根据 rTMS 实验和关于突触可塑性的知识，讨论 rTMS 效应的生理基础是否与突触可塑性的变化有关。我们提出了七点证据，强烈表明 rTMS 诱导的后效与诱导突触可塑性之间存在联系。然而，重要的是要意识到，目前不可能证明 rTMS 与突触可塑性之间存在直接联系。因此，我们为未来的创新研究提供了建议，旨在研究 rTMS 对突触的局部影响以及 rTMS 对大脑其他更全局组织水平的影响。只有这样，才能完全理解 rTMS 对大脑的后效。
