Koch Giacomo
Department of Neurosciences, Tor Vergata University General Hospital, Rome, Italy.
Funct Neurol. 2010 Jul-Sep;25(3):159-63.
Non-invasive brain stimulation methods, such as repetitive transcranial magnetic stimulation (rTMS), are currently used to modulate the excitability of the cerebral cortex, providing important insights into mechanisms of cortical plasticity. Used to create long-lasting changes in the excitability of synapses, rTMS has been intensively investigated as a therapeutic tool in several neurological and psychiatric conditions and given some promising results. Recent studies have shown that rTMS of cerebellar structures is capable of inducing long-lasting changes in the excitability of cerebello-thalamo-cortical pathways. Thus, this novel approach may be important for investigating the functions of cerebellar plasticity. Indeed, cerebellar rTMS has been shown to modulate motor control, cognitive functions, emotion and mood. Moreover, recent studies seem to indicate that long-lasting modifications of cerebellar pathways could be usefully exploited in the treatment of several pathological conditions characterized by altered cortical excitability, such as Parkinson's disease, stroke, depression and schizophrenia. The high potential of cerebellar rTMS as a therapeutic tool in neurology could depend on the possibility of modulating several interconnected remote areas, through the activation of different systems, such as the cerebello-thalamo-cortical and limbic-thalamo-cortical networks.
非侵入性脑刺激方法，如重复经颅磁刺激（rTMS），目前用于调节大脑皮层的兴奋性，为皮层可塑性机制提供了重要见解。rTMS用于在突触兴奋性方面产生持久变化，作为一种治疗工具，已在多种神经和精神疾病中得到深入研究，并取得了一些有前景的结果。最近的研究表明，对小脑结构进行rTMS能够在小脑-丘脑-皮层通路的兴奋性方面诱导持久变化。因此，这种新方法对于研究小脑可塑性的功能可能很重要。事实上，小脑rTMS已被证明可以调节运动控制、认知功能、情绪和心境。此外，最近的研究似乎表明，小脑通路的持久改变可有效用于治疗几种以皮层兴奋性改变为特征的病理状况，如帕金森病、中风、抑郁症和精神分裂症。小脑rTMS作为一种神经学治疗工具的巨大潜力可能取决于通过激活不同系统（如小脑-丘脑-皮层和边缘-丘脑-皮层网络）来调节多个相互连接的远程区域的可能性。
