[Stimulation of primary motor cortex and reorganization of cortical function]

The use of electrical motor cortex stimulation (EMCS) for post-stroke pain was established in Japan and has spread globally. EMCS has been used for the treatment of neuropathic pain, Parkinson's syndrome, and recovery of motor paresis. Since 2000, repetitive transcranial magnetic stimulation (rTMS) has been developed for the treatment of various neurological disorders. rTMS is a non-invasive method with almost no adverse effects. In the USA, rTMS of the left dorsolateral prefrontal cortex was approved for the treatment of major depression in 2008. rTMS of the primary motor cortex (M1) has been studied worldwide for the treatment of neuropathic pain, Parkinson's disease, motor paresis after stroke, and other neurological problems. For neuropathic pain, high-frequency rTMS of M1 is safe and significantly effective for consecutive 14 days. After cessation of rTMS, pain gradually returned within two weeks. For 'Kaifukuki' rehabilitation, high-frequency rTMS of affected M1 seemed to be effective for recovery of hand function. And even after cessation of rTMS, the recovery would be better than usual rehabilitation for two weeks. New methods and devices for rTMS therapy are under development, and rTMS of the M1 is likely to be established as an effective therapy for some neurological disorders.