理学療法ジャーナル57巻3号

2023年03月発行

特集 システムとしての姿勢制御—メカニズムの解明から臨床応用まで

ニューロモデュレーション技術を用いた姿勢制御アプローチ

著者： 犬飼康人¹

所属機関： ¹新潟医療福祉大学リハビリテーション学部理学療法学科

ページ範囲：P.313 - P.318

Point

●非侵襲的脳刺激法は中枢神経系に対する代表的なニューロモデュレーション技術である

●反復経頭蓋磁気刺激や経頭蓋電流刺激を用いて姿勢制御機能を改善させる取り組みが行われている

●前庭ノイズ電流刺激は姿勢制御機能を改善させる可能性がある，新たなニューロモデュレーション技術である

参考文献

1）Barker AT, et al：Non-invasive magnetic stimulation of human motor cortex. Lancet 1985；1：1106-1107

2）He W, et al：Protocols of non-invasive brain stimulation for neuroplasticity induction. Neurosci Lett 2020；719：133437. doi：10.1016/j.neulet.2018.02.045

3）Kricheldorff J, et al：Evidence of neuroplastic changes after transcranial magnetic, electric, and deep brain stimulation. Brain Sci 2022；12：929. doi：10.3390/brainsci12070929

4）Priori A, et al：Polarization of the human motor cortex through the scalp. Neuroreport 1998；9：2257-2260

5）Nandi T, et al：Increasing mediolateral standing sway is associated with increasing corticospinal excitability, and decreasing M1 inhibition and facilitation. Gait Posture 2018；60：135-140

6）Nandi T, et al：In standing, corticospinal excitability is proportional to COP velocity whereas M1 excitability is participant-specific. Front Hum Neurosci 2018；12：303. doi：10.3389/fnhum.2018.00303

7）Kaminski E, et al：Transcranial direct current stimulation（tDCS）over primary motor cortex leg area promotes dynamic balance task performance. Clin Neurophysiol 2016；127：2455-2462

8）Yosephi MH, et al：Multi-session anodal tDCS enhances the effects of postural training on balance and postural stability in older adults with high fall risk：primary motor cortex versus cerebellar stimulation. Brain Stimul 2018；11：1239-1250

9）Rehme AK, et al：Dynamic causal modeling of cortical activity from the acute to the chronic stage after stroke. Neuroimage 2011；55：1147-1158

10）Chang MC, et al：Enhancement of cortical excitability and lower limb motor function in patients with stroke by transcranial direct current stimulation. Brain Stimul 2015；8：561-566

11）Lin YN, et al：Effects of repetitive transcranial magnetic stimulation of the unaffected hemisphere leg motor area in patients with subacute stroke and substantial leg impairment：a pilot study. J Rehabil Med 2015；47：305-310

12）Baharlouei H, et al：The effect of transcranial direct current stimulation on balance in healthy young and older adults：a systematic review of the literature. Neurophysiol Clin 2020；50：119-131

13）Guo Z, et al：The effects of transcranial direct current stimulation（tDCS）on balance control in older adults：a systematic review and meta-analysis. Front Aging Neurosci 2020；12：275. doi：10.3389/fnagi.2020.00275

14）Kang N, et al：Functional balance and postural control improvements in patients with stroke after noninvasive brain stimulation：a meta-analysis. Arch Phys Med Rehabil 2020；101：141-153

15）Ghayour-Najafabadi M, et al：Repetitive transcranial magnetic stimulation for the treatment of lower limb dysfunction in patients poststroke：a systematic review with meta-analysis. J Stroke Cerebrovasc Dis 2019；28：104412. doi：10.1016/j.jstrokecerebrovasdis.2019.104412

16）Inukai Y, et al：Effect of noisy galvanic vestibular stimulation on center of pressure sway of static standing posture. Brain Stimul 2018；11：85-93

17）Inukai Y, et al：Effect of noisy galvanic vestibular stimulation in community-dwelling elderly people：a randomised controlled trial. J Neuroeng Rehabil 2018；15：63. doi：10.1186/s12984-018-0407-6

18）Inukai Y, et al：Noisy galvanic vestibular stimulation effect on center of pressure sway during one-legged standing. J Clin Neurosci 2020；82：173-178

19）Inukai Y, et al：The after-effect of noisy galvanic vestibular stimulation on postural control in young people：a randomized controlled trial. Neurosci Lett 2020；729：135009. doi：10.1016/j.neulet.2020.135009

20）McLaren R, et al：Efficacy of nGVS to improve postural stability in people with bilateral vestibulopathy：a systematic review and meta-analysis. Front Neurosci 2022；16：1010239. doi：10.3389/fnins.2022.1010239

21）Mitsutake T, et al：Comparing activated brain regions between noisy and conventional galvanic vestibular stimulation using functional magnetic resonance imaging. Neuroreport 2021；32：583-587