Транскраниальная магнитная стимуляция в детской неврологии

Транскраниальная магнитная стимуляция (ТМС) - это неинвазивная стимуляция мозга, которая применяется с исследовательскими и диагностическими целями, а также как один из методов нейромодуляции для лечения ряда болезней. В педиатрии ТМС чаще всего используется для оценки созревания кортикоспинального тракта. Для этого на моторные зоны коры головного мозга ребенка подается короткий одиночный импульсный магнитный стимул и регистрируются вызванные моторные ответы с разных мышц верхних и нижних конечностей, рассчитывается время центрального моторного проведения. Эта методика в детской неврологии также используется для определения нарушений проведения импульса по кортикоспинальному тракту и тестирования проявлений нейропластичности при повреждении двигательных зон коры головного мозга и нисходящих проводящих путей при таких заболеваниях, как детский церебральный паралич, инсульт, рассеянный склероз. Еще один аспект применения ТМС - оценка тормозных корковых механизмов с оценкой параметров коркового периода молчания и ипсилатерального периода молчания, которые часто меняются при поражениях центральной нервной системы. При проведении ТМС также можно выполнить картирование кортикальной представленности конкретной мышцы, что используется для оценки функциональных перестроек коры головного мозга при различных неврологических заболеваниях. Для точного выполнения картирования применяют сложное навигационное оборудование с использованием фокусной ТМС. В статье подробно описаны эти и другие диагностические методы ТМС, используемые при неврологических заболеваниях детского возраста, а также возможности терапевтического применения ритмической ТМС при неврологических заболеваниях.

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