Transkranielle Gleichstromstimulation: Neues Werkzeug in der Schmerztherapie?

Zusammenfassung

Mit dem Paradigma der transkraniellen Gleichstromstimulation (tDCS) haben wir eine Technik entwickelt die es ermöglicht, im Humanexperiment kortikale Erregbarkeitsmodifikationen nicht invasiv zu erzeugen, die über längere Zeit anhalten und somit wesentliche Kriterien extern modulierter Neuroplastizität erfüllen. tDCS bewirkt dies primär über eine Hyper- oder Depolarisierung neuronaler Membranen; die Nacheffekte sind NMDA-Rezeptor-abhängig. Klassisches Instrumentarium hierzu war bisher die repetitive transkranielle Magnetstimulation (rTMS), die über wiederholte kurz induzierte Stromflüsse im Gehirn ähnliche plastische Veränderungen erzielen kann. Wir setzen tDCS derzeit in der experimentellen Schmerzforschung ein, um einerseits Migräneattacken zu kupieren und andererseits chronische Schmerzen zu reduzieren.

Abstract

Transcranial direct current stimulation (tDCS) was developed by our group as a non-invasive tool to induce neuroplasticity in the human cerebral cortex. The primary effect of tDCS is a neuronal de- or hyperpolarisation; the after-effects are dependent upon NMDA receptor-efficacy changes. Applying repetitive transcranial magnetic stimulation (rTMS), a classical stimulation method, we can obtain similar plastic changes by inducing short current flows repeatedly in the brain. tDCS as a tool aims to induce prolonged neuronal excitability and activity alterations in the human brain in order to decrease the frequency of migraine attacks and attenuate subjective pain sensation in chronic pain.

Gleichstromstimulation - kortikale Erregbarkeit - Schmerztherapie - Migräne

tDCS - pain - cortical excitability - migraine

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