Positionierungsstrategien für die transkranielle Magnetstimulation

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

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