Funktionserholung nach Schlaganfall und die therapeutische Rolle der nicht-invasiven Hirnstimulation

Zusammenfassung

Im Bereich der non-invasiven Hirnstimulation stellen die transkranielle Magnetstimulation (engl. transcranial magnetic stimulation, TMS) sowie die transkranielle Gleichstromstimulation (engl. transcranial direct current stimulation, tDCS) bis heute die wichtigsten Techniken zur Modulation kortikaler Erregbarkeit dar. Beide Verfahren induzieren Nacheffekte, welche die Zeit der reinen Stimulation überdauern, und ebnen damit den Weg für ihren therapeutischen Einsatz beim Schlaganfall. In diesem Übersichtsartikel diskutieren wir die aktuelle Datenlage TMS- und tDCS-vermittelter Therapien für die häufigsten schlaganfallbedingten Defizite wie Hemiparese, Aphasie und Neglect. Darüber hinaus adressieren wir mögliche Einschränkungen der gegenwärtigen Ansätze und zeigen Ansatzpunkte auf, um Neuromodulation nach Schlaganfall effektiver zu gestalten und damit das Outcome der Patienten zu verbessern.

Abstract

Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) currently represent the most important techniques for modulating cortical excitability. Both approaches induce after-effects that outlast the time of stimulation, and thus form the foundation for their therapeutic use in stroke rehabilitation. The purpose of this review is to discuss current data on non-invasive stimulation therapies for the most common stroke-related deficits, i. e., hemiparesis, aphasia and neglect. In addition, we address current limitations and finally suggest strategies to potentially increase the effectiveness of neuromodulation after stroke in order to improve patients’ outcome.

Schlüsselwörter

Exzitabilität - Neurorehabiltiation - Plastizität - Neuromodulation - Hirnstimulation

Key words

Excitability - neurorehabilitation - plasticity - neuromodulation - brain stimulation

Publication History

Article published online:
29 October 2020

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