파킨슨과 비침습적 뇌자극 치료

TMS는 자기장을 이용하여 대<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">뇌신경에 반복적 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극을 하는 비침습적 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">치료로 현재 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">뇌신경학적 영역(재활의학과/신경과/신경외과) 및 정신과적 영역에서 사용되고 있습니다. 현재까지 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">치료법으로 소개된 질환은 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">뇌경색(<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">뇌출혈), 편두통, 우울증, 이명, <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">파킨슨병, 정신분열병,만성 통증 등이 있습니다. <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">뇌신경학적 영역에서 사용되는 예로서 첫번째로 single/paired TMS는 자기<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극을 한번(또는 쌍으로)시행하여 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극된 신경의 탈분극(depolarization)을 초래하며, 현재 motor evoked potential (MEP)와같은 검사용, 우울증 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">치료 등으로 사용되고 있습니다.두번째로 repetitive TMS(rTMS)는 자기<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극을 반복적으로 시행하여 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극된 대<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">뇌피질 (주로 cortico-spina tract)의 운동활성도를 높이거나 낮춥니다.rTMS의 parameter(<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극횟수, <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극의 세기, <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극기간, <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극사이 간격)은 아직 확실히 정의된 것은 없으나일반적으로 고빈도<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극(high frequency(5~20Hz)시 대<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">뇌피질의 운동활성도가 증가되며, 저빈도<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">자극(low frequency(1Hz)시 운동활성도가 감소된다고 알려져 있습니다. 이러한 TMS<span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">치료는 <span class="highlight" style="margin-top: 0px !important; margin-right: 0px !important; margin-bottom: 0px !important; margin-left: 0px !important; padding-top: 0px !important; padding-right: 0px !important; padding-bottom: 0px !important; padding-left: 0px !important; background-color: rgb(255, 255, 0) !important; color: rgb(0, 0, 0) !important; ">치료효과와 더불어 부작용의 가능성도 존재하며, 드물지만 간질발작(seizure), 졸도(syncope), 현기증(fainting) 의 가능성이 있습니다.