脳卒中における重複性トランスクラニアル磁気刺激による半球間変化の調査:トランスクラニアル磁気刺激とfNIRSの研究
Siqi Yang1,2,3, Yaomei Li2, Fen Zhang4
1Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Department of Rehabilitation Medicine, Shanghai, China.
Neurophotonics
|February 12, 2026
まとめ
低周波反復性トランスクレニアル磁気刺激 (rTMS) は,脳卒中後の運動回復を向上させ,半球間阻害と適応不良の接続性を減少させました. この神経調節アプローチは,パーソナライズされた脳卒中リハビリテーション戦略の可能性を秘めています.
科学分野:
- 神経科学は神経科学である.
- リハビリテーション医学 リハビリテーション医学
- バイオメディカルエンジニアリング
背景:
- 脳卒中後の半球間不均衡は,運動の回復を妨げます.
- 繰り返しのトランスクレニアル磁気刺激 (rTMS) は治療上の有望性を示しているが,脳卒中リハビリテーションのためのその神経機構は完全に理解されていない.
- パーソナライズされた神経調節の最適化には,rTMSが皮質刺激性と半球間相互作用に及ぼす影響を理解する必要があります.
研究 の 目的:
- 低周波rTMSが脳卒中患者の運動回復にどのように影響するかを調査する.
- rTMSが半球間阻害 (IHI),機能的接続性,および皮質刺激性に及ぼす影響を調査する.
- 神経生理学的変化と行動運動の結果を相関させる.
主な方法:
- 27人の脳卒中患者を対象としたランダム化制御試験で,2週間にわたり,逆転性原発運動皮質 (M1) 上での実際のまたは偽の1 Hz rTMS を受けた.
- IHIと横行率 (LQ) を評価するためにペアパルスTMSが使用されました.
- 機能的近赤外線スペクトロスコーピー (fNIRS) は,静止状態の機能的接続性 (RSFC) を測定し,臨床運動評価で補完しました.
主要な成果:
- 実際のrTMSは,収縮M1からイプシレシオンM1 (IHIの減少) への抑制駆動を著しく減少させた.
- 休息状態の機能的接続性分析は,収縮M1から,収縮前運動領域と補足運動領域への接続性の低下を示した.
- rTMSグループは,シームグループと比較して,LQと上肢運動機能のより大きな改善を示し,神経生理学的変化は運動の獲得と相関しています.
結論:
- 低周波rTMSは,皮質の興奮性を再均衡させ,適応不良の接続性を軽減することによって,脳卒中後の運動回復を促進します.
- TMSとfNIRSの併用は,rTMSが誘発した皮質の可塑性の証拠を提供します.
- これらの発見は,パーソナライズされた脳卒中リハビリテーションのための統合神経イメージングと神経調節ツールの可能性を強調しています.
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