Download PDF
Klinische Neurophysiologie 2005; 36(4): 173-177
DOI: 10.1055/s-2005-915322
Originalia
© Georg Thieme Verlag KG Stuttgart · New York

Bedeutung der Pulsform und der Stromflussrichtung bei TMS mit Einfach- und Doppelimpulsen sowie bei repetitiver TMS

Impact of Pulse Waveform and Current Direction for Single and Paired Pulse TMS and for Repetitive TMSM.  Sommer1 , W.  Paulus1
  • 1Abteilung Klinische Neurophysiologie, Georg-August-Universität Göttingen
Further Information

Publication History

Publication Date:
08 December 2005 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Pulsform und Stromflussrichtung beeinflussen die Effektivität transkranieller Magnetstimulation beim Menschen. Dies betrifft bei Einzelreizen die motorische Schwelle sowie die Dauer der Silent Period im Motorkortex und die Phosphenschwelle im visuellen Kortex, bei Doppelreizen das Verhältnis intrakortikaler Inhibition und Fazilitation in einem konventionellen Doppelreizparadigma der TMS über dem Motorkortex, und schließlich bei der repetitiven transkraniellen Magnetstimulation das Ausmaß und die Spezifität der im Motorkortex induzierten Bahnung und Hemmung. Mögliche Ursache dieser Unterschiede ist die unterschiedlich starke und verschieden selektive Aktivierung hemmender und bahnender Interneurone je nach Pulsform und Stromflussrichtung.

Abstract

Waveform and current direction determine the effectiveness of transcranial magnetic stimulation in humans. For single pulse TMS these factors have been shown to influence the motor threshold and the silent period duration detected by motor cortex stimulation and the phosphene threshold tested by occipital stimulation, for paired pulses they affect the balance of intracortical inhibition and facilitation within the motor cortex, and for repetitive stimulation the extent and specificity of the induced motor cortex inhibition and facilitation. Possibly, the extent and selectivity of activation of inhibiting and facilitating interneurons depend on TMS waveform and current direction.

Key words

TMS - waveform - current direction - excitability - intracortical

Literatur

  • 1 Barker A T, Jalinous R, Freeston I L. Non-invasive magnetic stimulation of human motor cortex (letter).  Lancet. 1985;  1 1106-1107
    PubMedGoogle Scholar
  • 2 Barker A T. Magnetic nerve stimulation. Basic principles and development. In: Nilsson J, Panizza M, Grandori F (eds) Advances in magnetic stimulation. Mathematical modeling and clinical applications. Pavia; Fondazione Salvatore Maugeri Edizioni 1996: 1-11
    Google Scholar
  • 3 Kimura J (Hrsg). Principles of nerve conduction studies.  In: Electrodiagnosis in diseases of nerve and muscle: principles and practice. Philadelphia; F. A. Davis 1989: 619
    Google Scholar
  • 4 Claus D. Motorisch evozierte Potentiale (MEP). In: Lowitsch K, Hopf HC, Buchner H, Claus D, Jörg J, Rappelsberger P, Tackmann W (Hrsg) Das EP-Buch. Stuttgart, New York; Thieme 2000: 173-232
    Google Scholar
  • 5 Maccabee P J, Nagaranjan S S, Amassian V E, Durand D M, Szabo A Z, Ahad A B, Cracco R Q, Lai K S, Eberle L P. Influence of pulse sequence, polarity and amplitude on magnetic stimulation of human and porcine periheral nerve.  J Physiol. 1998;  513 571-585
    CrossrefPubMedGoogle Scholar
  • 6 Jalinous R. Guide to the Magstim QuadroPulse. Spring Gardens; The Magstim Company 1995
    Google Scholar
  • 7 Bohning D E. Introduction and overview of TMS physics. In: George MS, Belmaker RH (eds) Transcranial magnetic stimulation in neuropsychiatry. Washington, D. C., London, England; American Psychiatric Press, Inc 2000: 13-44
    Google Scholar
  • 8 Corthout E, Barker A T, Cowey A. Transcranial magnetic stimulation Which part of the current waveform causes the stimulation?.  Exp Brain Res. 2001;  141 128-132
    CrossrefPubMedGoogle Scholar
  • 9 Lazzaro V Di, Oliviero A, Mazzone P, Insola A, Pilato F, Saturno E, Accurso A, Tonali P, Rothwell J C. Comparison of descending volleys evoked by monophasic and biphasic magnetic stimulation of the motor cortex in conscious humans.  Exp Brain Res. 2001;  141 121-127
    CrossrefPubMedGoogle Scholar
  • 10 Sommer M, Lang N, Tergau F, Paulus W. Neuronal tissue polarization induced by repetitive transcranial magnetic stimulation?.  Neuroreport. 2002;  13 809-811
    PubMedGoogle Scholar
  • 11 Sommer M, Tergau F, Wischer S, Paulus W. Paired-pulse repetitive transcranial magnetic stimulation of the human motor cortex.  Exp Brain Res. 2001;  139 465-472
    CrossrefPubMedGoogle Scholar
  • 12 Sommer M, Kamm T, Tergau F, Ulm G, Paulus W. Repetitive paired-pulse transcranial magnetic stimulation affects corticospinal excitability and finger tapping in Parkinson's disease.  Clin Neurophysiol. 2002;  113 944-950
    CrossrefPubMedGoogle Scholar
  • 13 Chiappa K H, Cros D, Cohen D. Magnetic stimulation: Determination of coil current flow direction.  Neurology. 1991;  41 1154-1155
    PubMedGoogle Scholar
  • 14 Niehaus L, Meyer B U, Weyh T. Influence of pulse configuration and direction of coil current on excitatory effects of magnetic motor cortex and nerve stimulation.  Clin Neurophysiol. 2000;  111 75-80
    CrossrefPubMedGoogle Scholar
  • 15 Kammer T, Beck S, Thielscher A, Laubis-Herrmann U, Topka H. Motor threshold in humans: a transcranial magnetic stimulation study comparing different pulse waveforms, current directions and stimulator types.  Clin Neurophysiol. 2001;  112 250-258
    CrossrefPubMedGoogle Scholar
  • 16 Brasil-Neto J P, Cohen L G, Panizza M, Nilsson J, Roth B J, Hallett M. Optimal focal transcranial magnetic activation of the human motor cortex: effects of coil orientation, shape of the induced current pulse, and stimulus intensity.  J Clin Neurophysiol. 1992;  9 132-136
    PubMedGoogle Scholar
  • 17 Ziemann U, Rothwell J C, Ridding M C. Interaction between intracortical inhibition and facilitation in human motor cortex.  J Physiol. 1996;  496 873-881
    PubMedGoogle Scholar
  • 18 Kammer T, Beck S, Erb M, Grodd W. The influence of current direction on phosphene thresholds evoked by transcranial magnetic stimulation.  Clin Neurophysiol. 2001;  112 2015-2021
    CrossrefPubMedGoogle Scholar
  • 19 Orth M, Rothwell J C. The cortical silent period: intrinsic variability and relation to the waveform of the transcranial magnetic stimulation pulse.  Clin Neurophysiol. 2004;  115 1076-1082
    CrossrefPubMedGoogle Scholar
  • 20 Kujirai T, Caramia M D, Rothwell J C, Day B L, Thompson P D, Ferbert A, Wroe S, Asselman P, Marsden C D. Corticocortical inhibition in human motor cortex.  J Physiol. 1993;  471 501-519
    CrossrefPubMedGoogle Scholar
  • 21 Peinemann A, Lehner C, Conrad B, Siebner H R. Age-related decrease in paired-pulse intracortical inhibition in the human primary motor cortex.  Neurosci Lett. 2001;  313 33-36
    CrossrefPubMedGoogle Scholar
  • 22 Tokimura H, Ridding M C, Tokimura Y, Amassian V E, Rothwell J C. Short latency facilitation between pairs of threshold magnetic stimuli applied to human motor cortex.  Electroencephalogr Clin Neurophysiol. 1996;  101 263-272
    CrossrefPubMedGoogle Scholar
  • 23 Ziemann U, Tergau F, Wassermann E M, Wischer S, Hildebrandt J, Paulus W. Demonstration of facilitatory I wave interaction in the human motor cortex by paired transcranial magnetic stimulation.  J Physiol (Lond). 1998;  511 181-190
    CrossrefPubMedGoogle Scholar
  • 24 Sommer M, Ruge D, Tergau F, Beuche W, Altenmüller E, Paulus W. Intracortical excitability in the hand motor representation in hand dystonia and blepharospasm.  Mov Disord. 2002;  17 1017-1025
    CrossrefPubMedGoogle Scholar
  • 25 Chen R, Classen J, Gerloff C, Celnik P, Wassermann E M, Hallett M, Cohen L G. Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation.  Neurology. 1997;  48 1398-1403
    CrossrefPubMedGoogle Scholar
  • 26 Muellbacher W, Ziemann U, Boroojerdi B, Hallett M. Effects of low-frequency transcranial magnetic stimulation on motor excitability and basic motor behavior.  Clin Neurophysiol. 2000;  111 1002-1007
    CrossrefPubMedGoogle Scholar
  • 27 Siebner H R, Tormos J M, Ceballos-Baumann A O, Auer C, Catala M D, Conrad B, Pascual-Leone A. Low-frequency repetitive transcranial magnetic stimulation of the motor cortex in writer's cramp.  Neurology. 1999;  52 529-537
    CrossrefPubMedGoogle Scholar
  • 28 Touge T, Gerschlager W, Brown P, Rothwell J. Are the after-effects of low-frequency rTMS on motor cortex excitability due to changes in the efficacy of cortical synapses?.  Clin Neurophysiol. 2001;  112 2138-2145
    CrossrefPubMedGoogle Scholar
  • 29 Narici L, Romani G L, Salustri C, Pizella V, Modena I, Papanicolaou A C. Neuromagnetic evidence of synchronized spontaneous activity in the brain following repetitive sensory stimulation.  Int J Neuroscience. 1987;  32 831-836
    PubMedGoogle Scholar
  • 30 Salmelin R, Hari R. Spatiotemporal characteristics of sensorimotor neuromagnetic rhythms related to thumb movement.  Neuroscience. 1994;  60 537-550
    CrossrefPubMedGoogle Scholar
  • 31 Antal A, Kincses T Z, Nitsche M A, Bartfai O, Demmer I, Sommer M, Paulus W. Pulse configuration dependent effects of repetitive transcranial magnetic stimulation on visual perception.  Neuroreport. 2002;  13 1-5
    PubMedGoogle Scholar
  • 32 Pascual-Leone A, Valls-Sole J, Wassermann E M, Hallett M. Responses to rapid-rate transcranial magnetic stimulation of the human motor cortex.  Brain. 1994;  117 847-858
    CrossrefPubMedGoogle Scholar
  • 33 Tings T, Lang N, Tergau F, Paulus W, Sommer M. Orientation-specific fast rTMS maximizes corticospinal inhibition and facilitation.  Exp Brain Res. 2005;  124 323-333
    PubMedGoogle Scholar
  • 34 Lazzaro V Di, Oliviero A, Saturno E, Pilato F, Insola A, Mazzone P, Profice P, Tonali P, Rothwell J C. The effect on corticospinal volleys of reversing the direction of current induced in the motor cortex by transcranial magnetic stimulation.  Exp Brain Res. 2001;  138 268-273
    CrossrefPubMedGoogle Scholar
  • 35 Lazzaro V Di, Oliviero A, Pilato F, Saturno E, Insola A, Mazzone P, Tonali P A, Rothwell J C. Descending volleys evoked by transcranial magnetic stimulation of the brain in conscious humans: effects of coil shape.  Clin Neurophysiol. 2002;  113 114-119
    CrossrefPubMedGoogle Scholar

Martin Sommer

Abteilung Klinische Neurophysiologie · Georg-August-Universität Göttingen

Robert-Koch-Straße 40

37075 Göttingen

Email: msommer@gwdg.de

      >