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Transcranial Magnetic Stimulation (TMS)

In transcranial magnetic stimulation (TMS), the nerve cells in the brain are stimulated by the magnetic fields. A device placed on the head regulates the brain activity.

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In our nerve cells, signals are generated and processed in the form of electric currents. Magnetic fields can generate electric currents and vice versa. Transcranial magnetic stimulation (TMS) is a non-invasive method, in which magnetic fields are used for the stimulation of the nerve cells. In other words, this method does not require interventional techniques like needles or interventions. The brain activities are regulated with the device placed on the head. A similar method is called transcranial direct current stimulation (tDCS). In this method, the device placed on the head affects the brain directly with the electric currents. Both TMS and tDCS have also inhibitory properties along with the stimulatory properties. Therefore, the term “modulation” is used to describe these diverse effects.

What Is The Goal Of The Transcranial Magnetic Stimulation?

In brain injuries like stroke, the activity of the damaged hemisphere is impaired while the activity of the contralateral hemisphere is increased. However, for a normal movement and functioning, both hemispheres should function in balance. The magnetic stimulation increases the activation of the damaged hemisphere and the hyperactivated contralateral hemisphere is suppressed. The repetitive transcranial magnetic stimulation (rTMS), which is applied before the rehabilitation sessions for 20 minutes, may prepare the brain to the therapy, increase the plasticity, and support the recovery. The magnetic field created by TMS may directly cause signal production in the nerve cells or may change only the excitability of the cells. Stimulation over the threshold is required for the signal generation in the nerve cells. The excitability of the nerve cells get near to this threshold or move away from it under the influence of the low-intensity TMS so that they become more or less excitable. If the intensity is increased, TMS may stimulate the nerve cells directly.

Repetitive transcranial magnetic stimulation (rTMS) administered for 20 minutes before rehabilitation sessions may make the brain more ready for therapy, improve plasticity and healing.

Transcranial Magnetic Stimulation In Stroke Treatment

In brain injuries like stroke, the activity of the damaged hemisphere is impaired while the activity of the contralateral hemisphere is increased. However, for a normal movement and functioning, both hemispheres should function in balance. The magnetic stimulation increases the activation of the damaged hemisphere and the hyperactivated contralateral hemisphere is suppressed. The repetitive transcranial magnetic stimulation (rTMS), which is applied before the rehabilitation sessions for 20 minutes, may prepare the brain to the therapy, increase the plasticity, and support the recovery. The magnetic field created by TMS may directly cause signal production in the nerve cells or may change only the excitability of the cells. Stimulation over the threshold is required for the signal generation in the nerve cells. The excitability of the nerve cells get near to this threshold or move away from it under the influence of the low-intensity TMS so that they become more or less excitable. If the intensity is increased, TMS may stimulate the nerve cells directly.

Transcranial Magnetic Stimulation In Stroke Treatment

It is well known that each cerebral hemisphere controls the opposite body part. However, for proper functioning in one side of the body, a balanced interaction between two hemispheres is needed. In this context, TMS increases the communication between the right and left hemispheres of the brain and thus contributes to the recovery of the paralyzed side of the body. Although stroke affects usually only one hemisphere of the brain, the recovery depends on the proper functioning of both hemispheres.

 

The goal of stroke rehabilitation is the regain of the mobility in the paralyzed side of the body. This is not possible unless both hemispheres work in harmony. During the rehabilitation, the exercises stimulate the generation of new neural circuits depending on the neuroplasticity of the brain. Magnetic stimulation is used as a supportive tool to increase the plasticity of the brain during the rehabilitation.

 

Magnetic brain stimulation is still a marginal technology and research is on-going. Although it is not routinely used in the rehabilitation of hemiplegia, preliminary results demonstrated its positive contribution to the recovery.