Transkranielle Gleichstromstimulation des menschlichen Gehirns – von den Grundlagen zur klinischen Anwendung

Zusammenfassung

Während in früheren Zeiten davon ausgegangen wurde, dass Struktur und Funktionen des Gehirns nach seiner Reifung weitgehend statisch sind, haben neuere Forschungsergebnisse ergeben, dass auch das adulte Gehirn ständig dynamischen, neuroplastischen Veränderungen unterworfen ist. Im gesunden Gehirn sind diese relevant für Lernen und Gedächtnisbildung, pathologische Veränderungen sind an einer Vielzahl neuropsychiatrischer Erkrankungen beteiligt. Die Entwicklung nicht-invasiver Hirnstimulationsverfahren erlaubt die Erforschung dieser Veränderungen am menschlichen Gehirn und ermöglicht die Beeinflussung pathologischer Plastizitätsprozesse. Die transkranielle Stimulation mit schwachem Gleichstrom (transcranial direct current stimulation, tDCS) ist ein Verfahren zur Erzeugung von Neuroplastizität des menschlichen Gehirns, das vor einigen Jahren eingeführt wurde. tDCS ermöglicht die Induktion lang anhaltender Erregbarkeitsveränderungen des menschlichen Gehirns. Darüber hinaus konnte belegt werden, dass diese Stimulation kognitive und Verhaltensprozesse sowie Symptome bei neuropsychiatrischen Erkrankungen beeinflussen kann, deren Grundlage neuroplastische Modifikationen des Gehirns sind. Diese Arbeit gibt einen Überblick über physiologische Funktionsmechanismen der tDCS sowie funktionelle Auswirkungen im gesunden und erkrankten menschlichen Gehirn.

Abstract

The classical opinion that brain function and structure are stable in adults has been challenged by recent research results, which show highly dynamic neuroplastic alterations during lifetime. These alterations are important for cognition and behaviour in the healthy brain, and pathological alterations contribute to many neuropsychiatric diseases. The development of non-invasive brain stimulation tools fostered the exploration of neuroplastic processes in the healthy human brain, and might also be suited to alter pathological neuroplastic processes. Transcranial stimulation with direct current (transcranial direct current stimulation, tDCS), which has been developed recently, is a tool suited for the induction of neuroplasticity in the human brain. It accomplishes the induction of long-lasting excitability alterations in the human cerebral cortex, and hereby enables the modification of cognition and behaviour. Moreover, it has been shown to improve clinical symptoms in those neuropsychiatric diseases that are accompanied by pathological alterations of neuroplasticity. This review gives an overview about the physiological basics of tDCS, as well as the functional effects in the healthy and the pathologically altered brain.

Schlüsselwörter

tDCS - Neuroplastizität - Rehabilitation - nicht-invasive Hirnstimulation

Key words

tDCS - neuroplasticity - rehabilitation - non-invasive brain stimulation

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