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Befunde Bei Verschiedenen Krankheiten

C. Fauth, B. Meyer, K. Müller, V. Hoemberg, R. Benecke, R. Knur, G. Küther, A. Ludolph, C. Bischoff
Published 1992 ·

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Seit der Entwicklung der transkraniellen elektrischen Kortexstimulation durch Merton u. Morton im Jahr 1980 wurden mit dieser Methode verschiedene Untersuchungen an Patienten mit Schlaganfallen und anderen Lasionen des Gehirns durchgefuhrt. Die dabei gewonnenen Ergebnisse konnten in den letzten Jahren durch die Magnetstimulation erganzt werden. Zunachst bemuhte man sich, Befunde zu sammeln und zu beschreiben (Berardelli et al. 1987; Thompson et al. 1987). Im weiteren kristallisierten sich jedoch zwei vor allem fur die rehabilitative Medizin wichtige Fragen heraus: Die eine betrifft die Moglichkeit einer prognostischen Aussage in der Fruhphase nach einem Schlaganfall (Macdonnel et al. 1989; Dominikus et al. 1990). Die andere bezieht sich auf Reorganisationsvorgange, die nach Hirnlasionen fur die motorische Funktionswiederkehr von Bedeutung sein konnten (Benecke et al. 1991; Fries et al. 1991). Von besonderem Interesse ist dabei, ob nach Lasionen Veranderungen im Projektionsmuster motorischer Fasersysteme auftreten, wie z.B. Abweichungen von der normalerweise ausschlieslich von der jeweils kontralateralen Hemisphare ausgehenden Versorgung distaler Armmuskeln. Eine wichtige Voraussetzung solcher Aussagen ist die Verfugbarkeit eines Stimulationsverfahrens, mit dem eine Hemisphare selektiv erregt werden kann. Gerade die Entwicklung sog. „fokaler“ Spulen (es handelt sich dabei um achtformig konfigurierte Doppelspulen, deren Stimulationsmaximum im Bereich der Spulentaille liegt) ermoglichte weitere Untersuchungen zu dieser Fragestellung (Claus et al. 1991).
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