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Brain
Brain
MRC Human Movement and Balance Unit ICN, UCL, UK Dr. John Rothwell Motor control
Institute of Neurology
http://www.icn.ucl.ac.uk/members/Rothw74
/
Human cortical physiology unit NIH, Maryland, USA Mark Hallett & Brain plasticity,
http://www.musc.edu/tmsmirror/news/tmsp Leonardo G. Cohen motor, vision
od.html
Departments of Psychiatry, Radiology, and Medical University Dr. Mark George Depression,
Neurology South Carolina, USA mapping,
http://www.musc.edu/tmsmirror/fMRI/TMS imaging
-fMRI.html
Cognitive Neuropsychology Laboratory Harvard University Dr. Alfonso Caramazza Language
http://www.wjh.harvard.edu/~caram/
Psychiatric Neuroimaging Group University of Bern, Thomas E. Schlaepfer, Psychiatry
Pni.unibe.ch/TMS.htm Switzerland M.D.
Related books:
1.
Transcranial Magnetic Stimulation: A Neurochronometrics of Mind (Bradford
Books)
by Vincent Walsh, Alvaro Pascual-Leone
(http://www.amazon.com/exec/obidos/tg/detail/-/0262232286/qid=1089365890/sr=1-
2/ref=sr_1_2/103-6297396-8804646?v=glance&s=books#product-details
)
2.
Transcranial Magnetic Stimulation in Neuropsychiatry
by Mark S. George, Robert H., M.D. Belmaker
(http://www.amazon.com/exec/obidos/tg/detail/-/0880489480/qid=1089365890/sr=1-
3/ref=sr_1_3/103-6297396-8804646?v=glance&s=books
)
3.
Handbook of Transcranial Magnetic Stimulation
by Alvaro Pascual-Leone, Eric Wasserman, Nick Davey & John Rothwell
(http://www.amazon.com/exec/obidos/tg/detail/-/0340720093/qid=1089365890/sr=1-
1/ref=sr_1_1/103-6297396-8804646?v=glance&s=books
)
4.
Stimulating the brain (2003). Mark S. George, Scientific American. 66-73.
(http://www.sciam.com/issue.cfm?issueDate=Sep-03
)
TMS 簡介:
歷史:
過去一百年來,精神科醫師常用電刺激療法(electroconvulsive therapy, ECT)
來治療憂鬱、躁症等患者,每次施行 ECT 治療需要先將病患麻醉,再將電極貼
於頭皮上,在治療的數週間,病患會有記憶的喪失的情況。此外,受顱骨的阻礙,
ECT 並不能準確的將刺激電流送入特定的腦區,反而是將刺激電流擴散到整個
腦部。相較於 ECT,穿顱磁刺激器(transcranial magnetic stimulation, TMS),具
有無痛、非侵入性及較能準確定位的特性,TMS 將電流轉換為磁場,再利用磁
場可穿透非導體的特性,穿過顱骨送入腦中,在相對位置下的數公分處,產生感
應電流。
TMS 在認知神經科學領域的發展,是從 Michael Faraday(1831)提出電磁
共生的理論(electromagnetic induction)開始,他指出磁場的變化可以產生感應
電流,加上 Du Bois-Reymond(1848)直接將電流連接到神經細胞,會引發神經
細胞活動,這個發現讓我們知道神經細胞的活化與電流有關。而 David Ferrier
(1875)更進一步利用電流刺激狗及猴子的大腦,找出腦中某些特殊區域與行為
的相關性。d’Arsonval(1896)應用上述發現,直接利用磁刺激的方式刺激視網
膜,發現會產生光幻視(phosphenes)現象,這是利用磁生電原理得到第一個生
理上的效果。此外,Polson 等人(1982)也利用磁刺激器(magnetic stimulator),
刺激周邊神經,並且記錄到 muscle evoked potential (MEP)。Barker 等人(1985)
更進一步的改良磁刺激器的設計,使得該儀器的能量轉換效率由 20%增加至
80%,因此他們想到運用這種儀器來直接刺激大腦,直接利用磁脈衝的方式,刺
激人類大腦運動皮質,成功的引發手部動作,並且記錄到手部肌肉動作電位變
化。由於 Barker 等人成功的利用磁刺激方式,刺激大腦皮質,使得 TMS 相關研
究迅速展開。
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Reference
Bohning, D. E., Shastri, A., Nahas, Z., Lorberbaum, J. P., Andersen, S. W., Dannels,
W. R., Haxthausen, E. U., Vincent, D. J. & George, M. S. Echoplanar BOLD fMRI
of brain activation induced by concurrent transcranial magnetic stimulation.
Invest. Radiol. 1998 Jun; 33(6): 336-340.
Paus T., Jech R., Thompson C.J., Comeau R., Peters T. & Evans AC. (1997).
Transcranial magnetic stimulation during positron emission tomography: a new
method for studying connectivity of the human cerebral cortex. J Neurosci. 17(9),
3178-84.
Polson M.J.R., Barker A. T. & Freeston I. L. (1982). Stimulation of nerve trunks with
time-varying magnetic fields. Med. Biol. Eng. Comput. 20, 243-244.