Transkranielle Magnetstimulation - eine neue Therapieoption bei Aphasie?

Zusammenfassung

Die repetitive transkranielle Magnetstimulation (rTMS) ist ein schmerzfreies, nicht- invasives Verfahren, bei dem über magnetische Felder bestimmte Hirnareale stimuliert werden können. Je nach Frequenz kann eine hemmende oder erregende Stimulation bewirkt werden. Die rTMS ist also je nach gewählter Repetitionsfrequenz in der Lage, bei Patienten mit Hirnschädigungen bestehende (kompensatorische) Überaktivierungen in bestimmten kortikalen Arealen zu hemmen bzw. im geschädigten Areal einen vorübergehenden Anstieg kortikaler Erregbarkeit zu bewirken. Deshalb ist die rTMS prinzipiell geeignet, zur Therapie bei Aphasiepatienten eingesetzt zu werden und insbesondere die Mechanismen der Spontanremission positiv zu beeinflussen. Zunächst wird im vorliegenden Überblicksartikel die Methode der rTMS vorgestellt, dann wird ein Überblick über die Ergebnisse bisheriger Studien zu Sprachverarbeitungsprozessen geliefert und über die rTMS Anwendung in der Aphasietherapie berichtet.

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a painless, non-invasive method of brain stimulation, which induces electric currents by using magnetic fields. The electric currents affect about 1-cm square area of the cortex. Slow frequency 1 Hz rTMS reduces cortical excitability whereas fast frequency (5, 10 or 20 Hz) leads to increasing cortical excitability. Therefore, rTMS can suppress (compensatory) over activation in the damaged hemisphere or increase cortical excitability in the non affected hemisphere. rTMS bears the potential for a new therapeutic procedure in patients with aphasia. One can assume that the treatment with rTMS supports the mechanisms of spontaneous recovery. Here we describe the procedure of rTMS. We will then present an overview of preliminary results from current neurolinguistic studies employing rTMS. Finally, the results of recent rTMS trials in aphasia treatment will be discussed.

Aphasietherapie - transkranielle Magnetstimulation - Spontanremission

aphasia treatment - transcranial magnetic stimulation - spontaneous recovery

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