Positionierungsstrategien für die transkranielle Magnetstimulation

C. Schönfeldt-Lecuona; M. Spitzer; U. Herwig

doi:10.1055/s-0038-1624391

Nervenheilkunde, Table of Contents

Nervenheilkunde 2003; 22(04): 177-181
DOI: 10.1055/s-0038-1624391

Original- und Übersichtsarbeiten/Original and Review Articles

Schattauer GmbH

Positionierungsstrategien für die transkranielle Magnetstimulation

Positioning strategies of the transcranial magnetic stimulation

Authors

C. Schönfeldt-Lecuona

¹Abteilung Psychiatrie III, Universitätsklinik Ulm (Direktor: Prof. Dr. med. Dr. phil. M. Spitzer)
M. Spitzer

¹Abteilung Psychiatrie III, Universitätsklinik Ulm (Direktor: Prof. Dr. med. Dr. phil. M. Spitzer)
U. Herwig

¹Abteilung Psychiatrie III, Universitätsklinik Ulm (Direktor: Prof. Dr. med. Dr. phil. M. Spitzer)

Abstract

Zusammenfassung

Die transkranielle Magnetstimulation (TMS) hat sich in den letzten Jahren aufgrund ihrer guten zeitlichen und zufriedenstellenden räumlichen Auflösung sowie der guten Verträglichkeit und Sicherheit und ihrer einfachen Praktikabilität als Forschungsinstrument in den Neurowissenschaften etabliert. Ein grundlegendes Problem bleibt jedoch die optimale Positionierung der Spule zur gezielten und fokussierten Stimulation. Die initial verwendeten Methoden zur Spulenpositionierung (in Anlehnung an das EEG-10-20-System, orientiert am Motorkortex oder an Landmarken) sind mittlerweile durch exaktere, aber auch kostenintensivere stereotaktische Positionierungsmethoden ergänzt worden. Diese neuen Techniken bedienen sich der Bildgebung, insbesondere der Magnetresonanztomographie. Rahmenlose optisch gesteuerte Neuronavigationssysteme können als komfortable und präzise Methode zur Spulenpositionierung angesehen werden. Unser Beitrag stellt verschiedene TMS-Positionierungsstrategien und -methoden vor.

Summary

In the past years transcranial magnetic stimulation (TMS) has become etablished as research tool in neurosciences due to its characteristics: high temporal resolution, innocuous effect of the magnetic fields and the easy practicability. One of the main difficulties of this method consists in finding the optimal coil position when trying a focused stimulation. The positioning methods initially used, e.g. oriented to the international EEG 10-20 system, oriented to the motor cortex or using specific landmarks, have been complemented by neuronavigational devises in the last years. These techniques are based on individual imaging data aquired prior to TMS. Optical tracked and frameless neuronavigation appears to be, due to its comfortable use and accuracy, the optimal positioning method for foccused TMS. Our manuscript adresses the issue of different coil positioning strategies, advantages and disadvantages.

Schlüsselwörter

Stereotaktische TMS - Neuronavigation - 3D-Kamerasystem - anatomische Landmarken

Keywords

Stereotactic TMS - neuronavigation - 3D camera system - anatomical landmarks

Full Text

References

Literatur
1 George MS, Belmaker RH. Transcranial magnetic stimulation in neuropsychiatry. Washington: American Psychiatric Press Inc: 2000.
2 Post RM, Kimbrell TA, McCann UD, Dunn RT, Osuch EA, Speer AM, Weiss SR. Repetitive transcranial magnetic stimulation as a neuropsychiatric tool: present status and future potential. J Ect 1999; 15: 39-59.
3 George MS, Lisanby SH, Sackeim HA. Transcranial magnetic stimulation: applications in neuropsychiatry. Arch Gen Psychiatry 1999; 56: 300-11.
4 Kammer T, Thielscher A. Physikalische und physiologische Grundlagen der transkraniellen Magnetstimulation. Nervenheilkunde 2003; 22: 168-76.
5 Roth BJ, Saypol JM, Hallett M, Cohen LG. A theoretical calculation of the electric field induced in the cortex during magnetic stimulation. Electroencephalogr Clin Neurophysiol 1991; 81: 47-56.
6 Kammer T, Spitzer M. [Triggered transcranial magnetic stimulation in high cognitive functions]. Fortschr Neurol Psychiatr 1996; 64: 205-11.
7 Cohen LG, Roth BJ, Nilsson J, Dang N, Panizza M, Bandinelli S, Friauf W, Hallett M. Effects of coil design on delivery of focal magnetic stimulation. Technical considerations. Electroencephalogr Clin Neurophysiol 1990; 75: 350-7.
8 Amassian VE, Cracco RQ, Maccabee PJ, Cracco JB, Rudell AP, Eberle L. Transcranial magnetic stimulation in study of the visual pathway. J Clin Neurophysiol 1998; 15: 288-304.
9 Pascual-Leone A, Gomez-Tortosa E, Grafman J, Alway D, Nichelli P, Hallett M. Induction of visual extinction by rapid-rate transcranial magnetic stimulation of parietal lobe. Neurology 1994; 44: 494-8.
10 Ashbridge E, Walsh V, Cowey A. Temporal aspects of visual search studied by transcranial magnetic stimulation. Neuropsychologia 1997; 35: 1121-31.
11 Kammer T, Nusseck H G. Are recognition deficits following occipital lobe TMS explained by raised detection thresholds?. Neuropsychologia 1998; 36: 1161-6.
12 Amassian VE, Cracco RQ, Maccabee PJ, Cracco JB, Rudell A, Eberle L. Suppression of visual perception by magnetic coil stimulation of human occipital cortex. Electroencephalogr Clin Neurophysiol 1989; 74: 458-62.
13 Barker A T, Jalinous R, Freeston IL. Non-invasive magnetic stimulation of human motor cortex. Lancet 1985; 01: 1106-7.
14 Epstein CM, Schwartzberg DG, Davey KR, Sudderth DB. Localizing the site of magnetic brain stimulation in humans. Neurology 1990; 40: 666-70.
15 Pascual-Leone A, Gates JR, Dhuna A. Induction of speech arrest and counting errors with rapid-rate transcranial magnetic stimulation. Neurology 1991; 41: 697-702.
16 Koppi S, Conca A, Swoboda E, Konig P. [Transcranial magnetic stimulation in depressed patients: a new antidepressive therapeutic principle? Presentation of a pilot trial]. Wien Med Wochenschr 1996; 146: 49-54.
17 Conca A, Koppi S, Konig P, Swoboda E, Krecke N. Transcranial magnetic stimulation: a novel antidepressive strategy?. Neuropsychobiology 1996; 34: 204-7.
18 Hufnagel A, Claus D, Brunhoelzl C, Sudhop T. Short-term memory: no evidence of effect of rapid-repetitive transcranial magnetic stimulation in healthy individuals. J Neurol 1993; 240: 373-6.
19 Hoffman RE, Boutros NN, Berman RM, Roessler E, Belger A, Krystal JH, Charney DS. Transcranial magnetic stimulation of left temporoparietal cortex in three patients reporting hallucinated »voices«. Biol Psychiatry 1999; 46: 130-2.
20 George MS, Wassermann EM, Williams WA, Callahan A, Ketter T A, Basser P, Hallett M, Post RM. Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in depression. Neuroreport 1995; 06: 1853-6.
21 Pascual-Leone A, Rubio B, Pallardo F, Catala MD. Rapid-rate transcranial magnetic stimulation of left dorsolateral prefrontal cortex in drug-resistant depression. Lancet 1996; 348: 233-7.
22 Herwig U, Padberg F, Unger J, Spitzer M, Schönfeldt-Lecuona C. Transcranial magnetic stimulation in therapy studies: Examination of the reliability of »standard« coil positioning. Biol Psychiatry 2001; 50: 58-61.
23 Levy WJ, Amassian VE, Schmid UD, Jungreis C. Mapping of motor cortex gyral sites noninvasively by transcranial magnetic stimulation in normal subjects and patients. Electroencephalogr Clin Neurophysiol Suppl 1991; 43: 51-75.
24 Bastings EP, Gage HD, Greenberg JP, Hammond G, Hernandez L, Santago P, Hamilton CA, Moody DM, Singh KD, Ricci PE, Pons TP, Good DC. Co-registration of cortical magnetic stimulation and functional magnetic resonance imaging. Neuroreport 1998; 09: 1941-6.
25 Wassermann EM, Grafman J, Berry C, Hollnagel C, Wild K, Clark K, Hallett M. Use and safety of a new repetitive transcranial magnetic stimulator. Electroencephalogr Clin Neurophysiol 1996; 101: 412-7.
26 Wirtz CR, Tronnier VM, Bonsanto MM, Hassfeld S, Knauth M, Kunze S. Neuronavigation: Methoden und Ausblick. Nervenarzt 1998; 69: 1029-36.
27 Paus T, Jech R, Thompson CJ, Comeau R, Peters T, Evans AC. Transcranial magnetic stimulation during positron emission tomography: a new method for studying connectivity of the human cerebral cortex. J Neurosci 1997; 17: 3178-84.
28 Krings T, Buchbinder BR, Butler WE, Chiappa KH, Jiang HJ, Cosgrove GR, Rosen BR. Functional magnetic resonance imaging and transcranial magnetic stimulation: complementary approaches in the evaluation of cortical motor function. Neurology 1997; 48: 1406-16.
29 Kammer T, Nusseck H G. A new method to measure and maintain the position of the magnetic coil with respect to the head. Electroencephalogr Clin Neurophysiol 1998; 107: 74.
30 Peters T, Davey B, Munger P, Comeau R, Evans A, Olivier A. Three-dimensional multimodal imag-guidance for neurosurgery. Trans Med Imag 1996; 15: 121-8.
31 Ettinger GJ, Leventon ME, Grimson WE, Kikinis R, Gugino L, Cote W, Sprung L, Aglio L, Shenton ME, Potts G, Hernandez VL, Alexander E. Experimentation with a transcranial magnetic stimulation system for functional brain mapping. Med Image Anal 1998; 02: 133-42.