理学療法ジャーナル55巻1号

2021年01月発行

Close-up 非侵襲的脳刺激 NIBS

tDCS 経頭蓋直流電気刺激

著者： 山口智史¹ 松田雅弘¹ 藤原俊之¹²

所属機関： ¹順天堂大学保健医療学部理学療法学科 ²順天堂大学医学部リハビリテーション医学

ページ範囲：P.75 - P.79

はじめに

　経頭蓋直流電気刺激（transcranial direct current stimulation：tDCS）は，頭皮上に貼付した刺激電極から1〜2mA程度の微弱な直流電流を3分から30分程度通電することで，頭蓋内の脳皮質の神経活動を高めるもしくは低下させることができる^1）．この特性を利用して脳活動を変調することで，中枢神経疾患後の運動機能や感覚機能，認知機能などのリハビリテーションの効果を促進することが期待されている．

　現在，tDCSの効果を明らかにするための基礎的および臨床的研究が世界中で盛んに行われている．本稿では，これまで明らかになってきた知見からtDCSの効果メカニズム，適応と禁忌，臨床応用の可能性について解説する．

参考文献

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2）Roche N, et al：Mechanisms underlying transcranial direct current stimulation in rehabilitation. Ann Phys Rehabil Med 2015；58：214-219

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10）Monai H, et al：Calcium imaging reveals glial involvement in transcranial direct current stimulation-induced plasticity in mouse brain. Nat Commun 2016；7：11100. doi：10.1038/ncomms11100

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16）Chen KS, et al：Invasive and non-invasive brain stimulation in Parkinson's disease：clinical effects and future perspectives. Clin Pharmacol Ther 2019；106：763-775

17）de Araújo AVL, et al：Effectiveness of anodal transcranial direct current stimulation to improve muscle strength and motor functionality after incomplete spinal cord injury：a systematic review and meta-analysis. Spinal Cord 2020；58：635-646

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19）Yamaguchi T, et al：The effects of anodal transcranial direct current stimulation and patterned electrical stimulation on spinal inhibitory interneurons and motor function in patients with spinal cord injury. Exp Brain Res 2016；234：1469-1478

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21）Fritsch B, et al：Direct current stimulation promotes BDNF-dependent synaptic plasticity：potential implications for motor learning. Neuron 2010；66：198-204

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24）Lee HK, et al：Does transcranial direct current stimulation improve functional locomotion in people with Parkinson's disease? A systematic review and meta-analysis. J Neuroeng Rehabil 2019；16：84. doi：10.1186/s12984-019-0562-4