Transkranielle Magnet- und Gleichstromstimulation bei Kopfschmerzen

Zusammenfassung

Seit einigen Jahren erlaubt die repetitive transkranielle Magnetstimulation (rTMS) und die transkranielle Gleichstromstimulation (tDCS) über eine Veränderung der neuronalen Aktivität oder des Ruhemembranpotenzials die Induktion und Modulation von neuroplastischen Veränderungen im Großhirn. tDCS erzielt prolongierte neuronale Erreg-barkeits- und Aktivitätsänderungen im menschlichen Gehirn über Veränderungen des neuronalen Membranpotenzials. rTMS ruft durch repetitiv induzierte elektrische Felder an den Zellmembranen über die Stimulationsdauer hinaus anhaltende Erregbarkeitsveränderungen hervor. Die Mehrzahl der neurophysiologischen Studien zur Pathophysiologie der Migräne stimmen darin überein, dass die Erregbarkeit des Gehirns der Patienten zwischen den Anfällen erhöht ist, besonders ausgeprägt in den visuellen Anteilen der Gehirnrinde. rTMS und tDCS eröffnen damit einen neuen Zugang sowohl zum Studium der pathophysiologischen Grundlagen als auch zu deren möglicher therapeutischer Beeinflussung.

Summary

In recent years, possibilities have emerged to manipulate ongoing neuroplastic changes by external modulation, either by interfering with neuronal activity or with neuronal membrane potentials in the human brain. tDCS asa tool aims to induce prolonged neuronal excitability and activity alterations via alterations of the neuronal membrane potential. rTMS produces continuous changes in excitability though repetitively induced electrical fields in the neuronal tissue. The majority of neuro-physiological studies on the pathophysiology of migraine agree that the cortical excitability is increased in patients between attacks, mainly in the visual areas of the cerebral cortex. Therefore, rTMS and tDCS open new possibilities for studying the pathophysiological basics of this disease and offer possible therapeutical methods.

Schlüsselwörter

Transkranielle Magnetstimulation - Gleichstromstimulation - Migräne - Schmerz - Kopfschmerz

Keywords

Transcranial magnetic stimulation - direct current stimulation - migraine - pain - headache

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