Single-pulse transcranial magnetic stimulation for assessment of motor development in infants with early brain injury.

Expert review of medical devices Pub Date : 2024-03-01 Epub Date: 2024-01-03 DOI:10.1080/17434440.2023.2299310
Ellen N Sutter, Cameron P Casey, Bernadette T Gillick
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Abstract

Introduction: Single-pulse transcranial magnetic stimulation (TMS) has many applications for pediatric clinical populations, including infants with perinatal brain injury. As a noninvasive neuromodulation tool, single-pulse TMS has been used safely in infants and children to assess corticospinal integrity and circuitry patterns. TMS may have important applications in early detection of atypical motor development or cerebral palsy.

Areas covered: The authors identified and summarized relevant studies incorporating TMS in infants, including findings related to corticospinal development and circuitry, motor cortex localization and mapping, and safety. This special report also describes methodologies and safety considerations related to TMS assessment in infants, and discusses potential applications related to diagnosis of cerebral palsy and early intervention.

Expert opinion: Single-pulse TMS has demonstrated safety and feasibility in infants with perinatal brain injury and may provide insight into neuromotor development and potential cerebral palsy diagnosis. Additional research in larger sample sizes will more fully evaluate the utility of TMS biomarkers in early diagnosis and intervention. Methodological challenges to performing TMS in infants and technical/equipment limitations require additional consideration and innovation toward clinical implementation. Future research may explore use of noninvasive neuromodulation techniques as an intervention in younger children with perinatal brain injury to improve motor outcomes.

单脉冲经颅磁刺激用于评估早期脑损伤婴儿的运动发育。
简介:单脉冲经颅磁刺激(TMS)在儿科临床人群中有很多应用,包括围产期脑损伤婴儿。作为一种无创神经调节工具,单脉冲经颅磁刺激已被安全地用于婴幼儿,以评估皮质脊髓的完整性和电路模式。TMS 在早期检测不典型运动发育或脑瘫方面可能有重要应用:作者确定并总结了对婴儿进行 TMS 的相关研究,包括与皮质脊髓发育和电路、运动皮层定位和映射以及安全性相关的研究结果。本特别报告还介绍了与婴儿 TMS 评估相关的方法和安全注意事项,并讨论了与脑瘫诊断和早期干预相关的潜在应用:单脉冲经颅磁刺激已在围产期脑损伤婴儿中证明了其安全性和可行性,并可为神经运动发育和潜在的脑瘫诊断提供洞察力。对更大样本量的其他研究将更全面地评估TMS生物标志物在早期诊断和干预中的效用。在婴儿中进行 TMS 所面临的方法学挑战和技术/设备限制需要更多的考虑和创新,以实现临床应用。未来的研究可能会探索使用非侵入性神经调控技术作为围产期脑损伤低龄儿童的干预措施,以改善运动效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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