Therapeutic rTMS in Neurology: Principles, Evidence, and Practice Recommendations

205 Pages·2016·4.396 MB·English

by  Thomas Platz (eds.)

Thomas Platz Editor
T herapeutic rTMS
in Neurology
Principles, Evidence,
and Practice
Recommendations
Therapeutic rTMS in Neurology

Thomas Platz
Editor
Therapeutic
rTMS in Neurology
Principles, Evidence, and Practice
Recommendations
Editor
Thomas Platz
BDH-Klinik Greifswald
Ernst-Moritz-Arndt Universität
Greifswald
Germany
ISBN 978-3-319-25719-8 ISBN 978-3-319-25721-1 (eBook)
DOI 10.1007/978-3-319-25721-1
Library of Congress Control Number: 2015958920
Springer Cham Heidelberg New York Dordrecht London
© Springer International Publishing Switzerland 2016
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Pref ace
Therapeutic repetitive transcranial magnetic stimulation (rTMS) in clinical neurol-
ogy is an emerging option to treat various neurological conditions. Many issues
need to be resolved for each condition treated and protocols developed with opti-
mized effectiveness taking individual subject characteristics into account. And yet,
the clinical benefi ts that can be achieved are at times remarkable and favor the clini-
cal application of rTMS therapy.
T his book is a comprehensive reference on therapeutic rTMS that documents the
current status in the fi eld. While introductory chapters cover the neurophysiology of
rTMS and present imaging information about its mechanisms of action, the main
focus of this book is the clinical applications of rTMS that have been tested to date.
These include treatment of paresis, aphasia, and visual neglect in stroke patients,
therapy for motor impairment in Parkinson’s disease, and applications for tinnitus
and neuropathic pain. Based on the available clinical evidence (RCTs, meta-analy-
ses, and systematic reviews), combined with the personal experience of experts in
the fi eld, a clinically oriented best evidence synthesis is provided for each therapeu-
tic application, together with a clear description of rTMS algorithms that generate
clinical benefi ts in the target domain.
Greifswald, Germany Thomas Platz
December 2015
v

Contents
1 Neurophysiology of rTMS: Important Caveats When
Interpreting the Results of Therapeutic Interventions . . . . . . . . . . . . 1
Masashi Hamada and John C. Rothwell
2 Cellular and Molecular Mechanisms of rTMS-induced
Neural Plasticity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Maximilian Lenz , Florian Müller-Dahlhaus , and Andreas Vlachos
3 Basic Principles of rTMS in Motor Recovery After Stroke . . . . . . . . 23
Lukas J. Volz and Christian Grefkes
4 Clinical Applications of rTMS in Motor
Rehabilitation After Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Thomas Platz
5 rTMS in Dysphagia After Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Jin-Woo Park
6 Basic Principles of rTMS in Aphasia Treatment After Stroke . . . . . . 73
Wolf-Dieter Heiss and Alexander Thiel
7 Therapeutic Applications of rTMS for Aphasia After Stroke . . . . . . 87
Priyanka P . Shah-Basak and Roy H. Hamilton
8 rTMS in Visual Hemineglect After Stroke . . . . . . . . . . . . . . . . . . . . . . 115
René M. Müri
9 Clinical Applications of rTMS in Parkinson’s Disease . . . . . . . . . . . . 129
Yuichiro Shirota , Masashi Hamada , and Yoshikazu Ugawa
10 rTMS in the Treatment of Neuropathic Pain . . . . . . . . . . . . . . . . . . . . 147
Jean-Pascal Lefaucheur
vii
viii Contents
11 Therapeutic Applications of rTMS for Tinnitus . . . . . . . . . . . . . . . . . 165
Berthold Langguth , Tobias Kleinjung , and Dirk De Ridder
12 Therapeutic rTMS in Neurology: Applications,
Concepts, and Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Thomas Platz
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
1
Neurophysiology of rTMS: Important
Caveats When Interpreting the Results
of Therapeutic Interventions
Masashi Hamada and John C. Rothwell
Abstract
Transcranial magnetic stimulation (TMS) is a safe and non-invasive method of
stimulating neurons in intact humans. TMS uses electromagnetic induction to
induce weak electric currents in the brain. There is good evidence that repetitive
application of TMS (repetitive TMS, rTMS) can produce after-effects, offering
potential for clinical application in variety of neurological and psychiatric dis-
eases. Although the mechanisms of this after-effect are not fully understood,
because of its similarity to synaptic plasticity in animals, it is generally assumed
that rTMS-induced effects may closely relate to synaptic plasticity, such as long-
term potentiation (LTP) or depression (LTD). Therefore, the term LTP- or LTD-
like is frequently used to describe the changes observed after rTMS. It has yet,
however, to be demonstrated that the site of rTMS-induced changes is the syn-
apse. Furthermore, the response to rTMS is highly variable. A number of factors
have been identifi ed that could contribute to this, but none of them accounts for
a large proportion of the effect. This unavoidable variability of rTMS hampers
attempts to assess treatment effectiveness. One potential approach to dealing
with this problem is to fi nd strong predictors of the response to rTMS so that
parameters of stimulation could be optimized on an individual basis. Another
would be to invent new non-invasive stimulation protocols that have more con-
sistent effects in all individuals. Variability in response to rTMS need not be seen
as a weakness of this method but a great opportunity to gain further insight into
individual differences in the awake human brain.
M. Hamada
Department of Neurology , Graduate School of Medicine, the University of Tokyo ,
Tokyo , Japan
J. C. Rothwell (*)
Sobell Department of Motor Neuroscience and Movement Disorders , UCL Institute of
Neurology, Queen Square, London , UK
e-mail: [email protected]
© Springer International Publishing Switzerland 2016 1
T. Platz (ed.), Therapeutic rTMS in Neurology: Principles, Evidence, and
Practice Recommendations, DOI 10.1007/978-3-319-25721-1_1