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Yıl:2017; Cilt: 10; Sayı: 2>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2017;10(2):72-78
Transkraniyal Manyetik Uyarım Cihazının Teknik Özellikleri ve Etki Mekanizması
A Bayram, N Tarhan
Üsküdar Üniversitesi, İstanbul
Transkraniyal manyetik uyarım (TMU), elektromanyetik indüksiyon prensibine dayalı, elektrot kullanılmadan elektriksel olarak serebral korteksin ve beyaz cevher yolaklarının uyarılmasını sağlayan bir yöntemdir. TMU cihazının ana ünitesi yüksek hızda değişen akımı vuruşlar şeklinde koile gönderir ve oluşturduğu manyetik alan ile beyinde indüksiyon akımı oluşturur. Bu derlemede ana ünitenin ve koilin teknik özellikleri hakkında bilgiler verilmiştir. TMU koilleri tasarım şekline göre farklı odaklama değerlerine ve farklı uyarım derinliklerine sahip olabilir. Günümüzde derin ve odaklı uyarımı aynı anda başaran bir koil tasarımı mevcut değildir. Farklı koil türlerinin derinlik ve odaklama açısından sağladığı avantaj ve dezavantajlar bu çalışmada değerlendirilmiştir. TMU yönteminin etkin özelliği ise tekrarlı TMU protokollerinden gelir. Tekrarlı TMU'nun özellikle depresyonda terapötik etkinliği fizyolojik etki mekanizmasıyla ilişkilidir. Tekrarlı TMU etki mekanizması netlik kazanmamış olsa da farklı frekanslarda yapılan uygulamaların kortikal uyarılabilirlik, kortikal inhibisyon, kortikal güçlenme, kortikal plastisite gibi fizyolojik parametreler üzerine etkileri bu incelemede ele alınmıştır.
Technical Properties of the Transcranial Magnetic Stimulation Device and Mechanism of Action
Transcranial magnetic stimulation (TMS) is a technique based on electromagnetic induction whereby cerebral cortex can be stimulated electrically without electrodes. Main TMS unit sends pulses namely rapidly changing currents through coil, which in turn induces current in the brain via changing magnetic field. In this review technical properties of the main unit and the coil were presented. TMS coils could exhibit varied stimulation depths and focality values according to their design. Nowadays there isn't any coil design achieved deep and focal stimulation simultaneously. Thus, pros and cons of different coil types were evaluated based on depth and focality. Effective aspect of TMS application stems from repetitive stimulation protocols. The mechanism of action of the repetitive TMS associated especially with therapeutic recovery in depression. Despite the mechanism of action is uncertain, the changes in physiological parameters such as cortical excitability, inhibition and facilitation, and plasticity, were investigated in this review.

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