Die Triple-Stimulationstechnik

Zusammenfassung

Die Triple-Stimulationstechnik (TST) ist eine neurophysiologische Kollisionsmethode, welche die durch einen transkraniellen Magnetstimulus ausgelösten spinalen Motoneuronentladungen synchronisiert. Durch diese Synchronisierung werden Phasenkanzellationsphänomene eliminiert, welche die Amplitude der Reizantwort sonst in unvorhersehbarer und variierender Weise reduzieren würden. Zusätzlich eliminiert die TST auch Einflüsse multipler spinaler Motoneuronentladungen nach transkranieller Magnetstimulation. Die TST vermag es, die Anzahl leitender zentraler Motoneurone zu einem Zielmuskel in Prozentwerten zu quantifizieren. Beim Patienten eignet sie sich zum Nachweis und zur Messung zentraler Leitungsdefizite, die durch Verlust oder Leitungsblock kortikospinaler Neurone entstanden sind. Die TST weist eine hohe diagnostische Sensitivität auf und gewährt neue Einblicke in die Physiologie der transkraniellen Magnetstimulation und der zentralen Motorik.

Abstract

The triple stimulation technique (TST) is a neurophysiological collision method. It synchronizes spinal motor neuron discharges which were evoked by a transcranial magnetic brain stimulus. This synchronization eliminates phase cancellation phenomena which would reduce the response size in an unpredictable and varying manner. In addition, the TST eliminates influences of multiple spinal motor neuron discharges in response to the brain stimulus. The TST quantifies the percentage of a target muscle's motor neuron pool that was driven to discharge by the transcranial stimulus. In patients, it has a high diagnostic sensitivity in measuring central motor conduction deficits caused by loss or conduction block of cortico-spinal neurons.

Key words

Transcranial magnetic stimulation - triple stimulation technique - collision technique - amyotrophic lateral sclerosis - multiple sclerosis

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