• 検索結果がありません。

結論

ドキュメント内 九州大学学術情報リポジトリ (ページ 82-93)

5 結論

- 81 -

rTMS は、皮質興奮特性の変化を誘発することができることから、様々な分 野において活用されている。1 HzのrTMSによりMEPが減少することはよく知 られているが、被験者、刺激条件によっては、1 HzのrTMSによりMEPが増加 したという相反する報告も存在する。1 Hz以下のrTMSにおいて、抑制効果が 誘発される被験者と促進効果が誘発される被験者は、どこに違があるのか明確 になっていない。本論文では、MEP の波形は、大脳皮質の興奮性を反映してい ることから、rTMSを与える前のMEPの特徴量に着目した。そして、rTMSが誘 発する刺激効果の個人差の原因がどこにあるのかを特定するために、rTMSの刺 激効果とrTMS を与える前の MEP の特徴量の関係を調べた。更に、rTMSの刺 激条件設定に役立てるため、rTMSの刺激効果が誘発されやすい被験者と誘発さ れにくい被験者における近似モデルを作成し、rTMSの刺激効果の推定を試みた。

本研究により、刺激前の MEP の振幅と立上り潜時が刺激効果に影響を与え ることが明確になった。特に、振幅が小さく潜時が早い被験者において、抑制 効果が誘発されにくいこと、一方で、振幅が大きく潜時が遅い被験者において、

抑制効果が誘発されやすいことが分かった。更に、MEP のこれらの特徴量と rTMS の刺激効果の間には、負の相関があることが分かった。これらの結果は、

rTMS の刺激効果における、ばらつきの要因の一つを特定したとも考えられる。

更に、近似モデルを作成し、rTMSの刺激条件である刺激強度とパルス数を入力

結論

- 82 -

することで、rTMSが誘発するMEPの振幅変化の推定を行うことを可能にした。

本論文は、rTMS の刺激効果に影響を被験者の特徴を明らかにしたものであ り、rTMSによる治療の効果の向上やrTMSを用いた脳機能計測に関する研究の 一助となり得る。本論文の結果を用いることで、治療計画や実験計画を検討し、

効率のよい計画を立てることで、被験者の負担を減らし、より有効な治療、実 験を行うことにも繋がると考えられる。

- 83 -

参考文献 :

Arsonval AD., “Dispotifs pour la mesure des courants alternatifs de toutes frequencies”, C. R. Acad. Sci., Vol. 48, pp. 450, 1896.

Barker T., Jalinous R., Freeston IL., “Non-invasive magnetic stimulation of human motor cortex”, The Lancet, Vol. 1, No. 8437, pp. 1106-1107, 1985.

Berardelli A., Inghilleri M., Rothwell JC., Romeo S., Currá A., Gilio F., Modugno N., Manfredi M., “Facilitation of muscle evoked responses after repetitive cortical stimulation in man”, Experimental Brain Research, Vol. 122, No. 1, pp. 79-84, 1998.

Berger U., Korngreen A., Bar-Gad I., Friedman A., Wolfus S., Yeshurun Y., Lavidor M., “Magnetic stimulation intensity modulates motor inhibition”, Neuroscience Letters, Vol. 504, No. 2, pp. 93-97, 2011.

Caparelli E., Backus W., Telang F., Wang G., Maloney T., Goldstein R., Henn F.,

“Is 1 Hz rTMS always inhibitory in healthy individuals?”, The open Neuroimaging Journal, Vol. 6, pp.69-74, 2012.

Caramia MD., Bernardi G., Zarola F., Rossini PM., “Neurophysiological evaluation of the central nervous impulse propagation in patients with sensorimotor disturbances”, Electroencephalography and Clinical Neurophysiology, Vol. 70, No. 1, pp. 16-25, 1988.

Chen R., Classen J., Gerloff C., Celnik P., Wassermann EM., Hallett, Cohen LG.,

“Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation” Neurology, Vol. 48, pp.1398-1403, 1997.

- 84 -

Cowey A., “The Ferrier Lecture 2004 what can transcranial magnetic stimulation tell us about how the brain works?”, Philosophical Transactions of the Royal Society London B: Biological Sciences, Vol.360, pp.1185-1205, 2005.

Eguchi Y., Ogiue-Ikeda M., Ueno S.,” Control of orientation of rat Schwann cells using an 8-T static magnetic field”, Neuroscience Letters, Vol.351, No. 2, pp.130-132, 2003.

Epstein CM., Woodard JL., Stringer AY., Bakay RA., Henry TR., Pennell PB., Litt B., “Repetitive transcranial magnetic stimulation does not replicate the Wada test”, Neurology, Vol.55, pp.1025-1027, 2000.

Filipović SR., Rothwell JC., Bhatia K., “Slow (1 Hz) repetitive transcranial magnetic stimulation (rTMS) induces a sustained change in cortical excitability in patents with Parkinson’s disease”, Clinical Neurophysiology, Vol. 121, No. 7, pp.1129-1137, 2010.

Fischer M., Orth M.,” Short-latency sensory afferent inhibition: conditioning stimulus intensity, recording site, and effects of 1 Hz repetitive TMS”, Brain Stimulation, Vol.4, No.4, pp.202-209, 2011.

Fitzgerald PB., Brown TL., Daskalakis ZJ., Chen R., Kulkarni J.,

“Intensity-dependent effects of 1Hz rTMS on human corticospinal excitability”, Clinical Neurophysiology, Vol. 113, No. 7, pp. 1136-1141, 2002.

Fitzgerald PB., Fountain S., Daskalakis ZJ. “A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition”, Clinical Neurophysiology, Vol.117, pp.2584-2596, 2006.

Fregni F., Pascual-Leone A., “Technology insight: noninvasive brain stimulation

参考文献

- 85 -

in neurology-perspectives on the therapeutic potential of rTMS and tDCS”, Nature Clinical Practice Neurology, Vol.3, pp.383-93, 2007.

Gangitano M., Valero-Cabré A., Tormos JM., Mottaghy FM., Romero JR., Pascual-Leone A., “Modulation of input-output curves by low and high frequency repetitive transcranial magnetic stimulation of the motor cortex”, Clinical Neurophysiology, Vol. 113, No. 8, pp. 1249-1257, 2002.

George MS., Wassermann EM., Williams WA., Callahan A., Ketter TA., Basser P., Hallett M., Post RM., “Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in depression”, Neuroreport, Vol. 6, No. 14, pp. 1853–

1856, 1995.

George MS., Post RM., “Daily Left Prefrontal Repetitive Transcranial Magnetic Stimulation for Acute Treatment of Medication-Resistant Depression”, The American Journal of Psychiatry, Vol. 168, No. 4, pp.356-364, 2011.

Groppa S., Oliviero A., Eisen A., Quartarone A., Cohen LG., Mall V., Kaelin-Lang A., Mima T., Rossi S., Thickbroom GW., Rossini PM., Ziemann U., Valls-Solé J., Siebner HR., “A practical guide to diagnostic transcranial magnetic stimulation: report of an IFCN committee”, Clinical Neurophysiology, Vol. 123, No. 5, pp. 858-882, 2012.

Hallett M., “Transcranial magnetic stimulation: a primer”, Neuron, Vol. 55, No.

2, pp. 187-199, 2007.

Hamada M., Murase N., Hasan A., Balaratnam M., Rothwell JC., “The Role of Interneuron Networks in Driving Human Motor Cortical Plasticity”, Cerebral Cortex, Vol.23, pp. 1593-1605, 2013.

- 86 -

Hess G., Donoghue JP., “Long-term depression of horizontal connections in rat motor cortex”, European Journal of Neuroscience, Vol.8, No.4, pp. 658-665, 1996.

Hummel FC., Cohen LG., “Non-invasive brain stimulation: a new strategy to improve neurorehabilitation after stroke?”, Lancet Neurology, Vol. 5, No. 8, pp.

708-712, 2006.

Iezzi E., Suppa A., Conte A., Li Voti P., Bologna M., Berardelli A., “Short-term and long-term plasticity interaction in human primary motor cortex”, The European Journal of Neurosciene, Vol.33, No.10, pp.1908-1915, 2011.

Kantak SS., Fisher BE., Sullivan KJ., Winstein CJ., “Effects of different doses of low frequency rTMS on motor corticospinal excitability”, Journal of Neurology and Neurophysiology, Vol.1, No.1, pp.1-6, 2010.

Kasai T., Kawai S., Kawanishi M., Yahagi S., “Evidence for facilitation of motor evoked potentials (MEPs) induced by motor imagery”, Brain Research, Vol.744, pp.147-150, 1997.

Kramer AF., Erickson KI., “Capitalising on cortical plasticity: influence of physical activity on cognition and brain function.”, Trends in Cognitive Sciences, Vol.11, No.8, pp.342–348, 2007.

Lang N., Harms J., Weyh T., Lemon RN., Paulus W., Rothwell JC., Siebner HR.,

“Stimulus intensity and coil characteristics influence the efficacy of rTMS to suppress cortical excitability”, Clinical Neurophysiology, Vol. 117, No. 10, pp.

2292-2301, 2006.

Lazzaro VD., Oliviero A, Pilato F., Saturno E., Dileone M., Mazzone P., Insola

参考文献

- 87 -

A., Tonali PA., Rothwell JC., “The physiological basis of transcranial motor cortex stimulation in conscious humans”, Clinical Neurophysiology, Vol.115, pp.255-266, 2004.

Lazzaro VD., Pilato F., Dileone M., Profice P., Oliviero A., Mazzone P., Insola A., Ranieri F., Tonali PA., Rothwell JC., “Low-frequency repetitive transcranial magnetic stimulation suppresses specific excitatory circuits in the human motor cortex”, The Journal of Physiology, Vol. 586, No. 18, pp. 4481-4487, 2008.

Lazzaro VD., Profice P., Pilato F., Dileone M., Oliviero A., Ziemann U., “The effect of motor cortex rTMS on corticospinal descending activity”, Clinical Neurophysiology, Vol. 121, No. 4 pp. 464-473, 2010.

Lazzaro VD., Profice P., Ranieri F., Capone F., Dileone M., Oliviero A., Pilato F.,

“I-wave origin and modulation”, Brain Stimulation, Vol. 5, pp.512-525, 2012 Leung A., Donohue M., Xu R., Lee R., Lefaucheur JP., Khedr EM., Saitoh Y., André-Obadia N., Rollnik J., Wallace M., Chen R., “rTMS for Suppressing Neuropathic Pain: A Meta-Analysis”, The Journal of Pain, Vol. 10, No. 12, pp.

1205-1216, 2009.

Maeda F., Keenan JP., Tormos JM., Topka H., Pasvual-leone A., “Inter individual variability of the modulatory effects of repetitive transcranial magnetic stimulation on cortical excitability”, Experimental Brain Research, Vol. 133, No.

4, pp. 425-430, 2000a.

Maeda F, Keenan JP., Tormos JM., Topka H., Pascual-Leone A., “Modulation of corticospinal excitability by repetitive. transcranial magnetic stimulation”, Clinical Neurophysiology, Vol. 111, No. 5, pp. 800-805, 2000b.

- 88 -

Migita K., Uozumi T., Arita K., Monden S., “Transcranial magnetic coil stimulation of motor cortex in patients with central pain”, Neurosurgery, Vol. 36, No. 5, pp. 1037-1039, 1995.

Muellbacher W., Ziemann U., Boroojerdi B., Hallett M., “Effects of low-frequency transcranial magnetic stimulation on motor excitability and basic motor behavior”, Clinical Neurophysiology, Vol. 111, No. 6, pp. 1002-1007, 2000.

Muller P.A., Dhamne S.C., Vahabzadeh-Hagh A.M., Pascual-Leone A., Jensen F.E., Rotenberg A., “Suppression of motor cortical excitability in anesthetized rats by low frequency repetitive transcranial magnetic stimulation” PloS one, Vol.

9, No.3, e91065, 2014.

Murase N., Rothwell JC., Kaji R., Urushihara R., Nakamura K., Murayama N., Igasaki T., Sakata-Igasaki M., Mima T., Ikeda A., Shibasaki H., “Subthreshold low-frequency repetitive transcranial magnetic stimulation over the premotor cortex modulates writer’s cramp”, Brain, Vol. 128, No. 1, pp. 104-115, 2005.

Málly J., Dinya E., “Recovery of motor disability and spasticity in post-stroke after repetitive transcranial magnetic stimulation (rTMS)”, Brain Research Bulletin, Vol. 76, No. 4, pp. 388-395, 2008.

Nielsen JF., “Improvement of amplitude variability of motor evoked potentials in multiple sclerosis patients and in healthy subjects”, Electroencephalography and Clinical Neurophysiology, Vol.101, pp.404-411, 1996.

Pascual-Leone A., Valls-Solé J., Brasil-Neto JP., Cohen LG., Hallett M.,

“Akinesia in Parkinson's disease. I. Shortening of simple reaction time with focal, single-pulse transcranial magnetic stimulation.”, Neurology, Vol. 44, No. 5, pp.

参考文献

- 89 -

884-891, 1994a.

Pascual-Leone A., Valls-Solé J., Brasil-Neto JP., Cammarota A., Grafman J., Hallett M., “Akinesia in Parkinson’s disease. II. Effects of subthreshold repetitive transcranial motor cortex stimulation.”, Neurology, Vol. 44, No. 5, pp. 892-898, 1994b.

Pascual-Leone A., Valls-Sole J., Wassermann EM., Hallett M., “Responses to rapid-rate transcranial magnetic stimulation of the human motor cortex”, Brain, Vol. 117, No. 4, pp. 847-858, 1994c.

Peinemann A., Reamer B., Löer C., Quartarone A., Münchau A., Conrad B., Siebner HR., “Long-lasting increase in corticospinal excitability after 1800 pulses of subthreshold 5 Hz repetitive TMS to the primary motor cortex”, Clinical Neurophysiology, Vol. 115, No. 7, pp. 1519-1526, 2004.

Ridding MC., Ziemann U., “Determinants of the induction of cortical plasticity by non-invasive brain stimulation in healthy subjects” The journal of physiology, Vol.588, pp. 2291-304, 2010.

Rothwell JC., “Techniques and mechanisms of action of transcranial stimulation of the human motor cortex”, Journal of Neuroscience Methods, Vol. 74, No. 2, pp.

113-122, 1997.

Robertson EM., Theoret H., Pascual-Leone A., “Studies in Cognition: The Problems Solved and Created by Transcranial Magnetic Stimulation”, Journal of Cognitive Neuroscience, Vol.15, pp.3948-965, 2003.

Siebner HR., Tormos JM., Ceballos-Baumann AO., Auer C., Catala MD., Conrad B., Pascual-Leone A., “Low-frequency repetitive transcranial magnetic

- 90 -

stimulation of the motor cortex in writer's cramp”, Neurology, Vol. 52, No. 3, pp.

529-537, 1999.

Sommer M., Rummel M., Norden C., Rothkegel H., Lang N., Paulus W., ” Mechanisms of human motor cortex facilitation induced by subthreshold 5-Hz repetitive transcranial magnetic stimulation.” Journal of Neurophysiology, Vol.109, No.12, pp. 3060-3066, 2013.

Sun SJ., Tobimatsu S., Kato M., ”The effect of magnetic coil orientation on the excitation of the median nerve.”, Acta Neurologica Scandinavica, Vol.97, No. 5, pp.328-35, 1998.

Traversa R., Cicinelli P., Pasqualetti P., Filippi M., Rossini PM., “Follow-up of interhemispheric differences of motor evoked potentials from the 'affected' and 'unaffected' hemispheres in human stroke”, Brain Research, Vol.803, pp.1-8, 1998.

Tergau F., Naumann U., Paulus W., Steinhoff BJ., “Low-frequency repetitive transcranial magnetic stimulation improves intractable epilepsy”, The Lancet, Vol.

353, No. 9171, pp. 2209, 1999.

Theodore WH., Fisher RS., “Brain stimulation for epilepsy”, Lancet Neurology, Vol. 3, No. 2, pp.111-118, 2004.

Thompson SP., “A physiological effect of an alternating magnetic field”, Proceedings of the Royal Society, Vol. 82, No. 557, pp. 396-398, 1910.

Touge T., Gerschlager W., Brown P., Rothwell JC., “Are the after-effects of low-frequency rTMS on motor cortex excitability due to change in the efficacy of cortical synapses”, Clinical Neurophysiology, Vol. 112, No. 11, pp. 2138-2145,

ドキュメント内 九州大学学術情報リポジトリ (ページ 82-93)

関連したドキュメント