Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
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A Review on Effects of Non-Invasive Brain Stimulation in the Treatment of Sleep Disorders

수면장애에서 비침습적 뇌자극술의 치료 효과 고찰: 경두개자기자극술과 경두개직류전기자극술을 중심으로

  • Kim, Shinhye (Ewha Brain Institute, Ewha Womans University) ;
  • Lee, Suji (Ewha Brain Institute, Ewha Womans University) ;
  • Lim, Soo Mee (Department of Radiology, Ewha Womans University College of Medicine) ;
  • Yoon, Sujung (Ewha Brain Institute, Ewha Womans University)
  • 김신혜 (이화여자대학교 뇌융합과학연구원) ;
  • 이수지 (이화여자대학교 뇌융합과학연구원) ;
  • 임수미 (이화여자대학교 의과대학 영상의학교실) ;
  • 윤수정 (이화여자대학교 뇌융합과학연구원)
  • Received : 2021.11.04
  • Accepted : 2021.11.24
  • Published : 2021.12.31
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Abstract

Sleep disorders, increasingly prevalent in the general population, induce impairment in daytime functioning and other clinical problems. As changes in cortical excitability have been reported as potential pathophysiological mechanisms underlying sleep disorders, multiple studies have explored clinical effects of modulating cortical excitability through non-invasive brain stimulation in treating sleep disorders. In this study, we critically reviewed clinical studies using non-invasive brain stimulation, particularly transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), for treatment of sleep disorders. Previous studies have reported inconsistent therapeutic effects of TMS and tDCS for various kinds of sleep disorders. Specifically, low-frequency repetitive TMS (rTMS) and cathodal tDCS, both of which exert an inhibitory effect on cortical excitability, have shown inconsistent therapeutic effects for insomnia. On the other hand, high-frequency rTMS and anodal tDCS, both of which facilitate cortical excitability, have improved the symptoms of hypersomnia. In studies of restless legs syndrome, high-frequency rTMS and anodal tDCS induced inconsistent therapeutic effects. Single TMS and rTMS have shown differential therapeutic effects for obstructive sleep apnea. These inconsistent findings indicate that the distinctive characteristics of each non-invasive brain stimulation method and specific pathophysiological mechanisms underlying particular sleep disorders should be considered in an integrated manner for treatment of various sleep disorders. Future studies are needed to provide optimized TMS and tDCS protocols for each sleep disorder, considering distinctive effects of non-invasive brain stimulation and pathophysiology of each sleep disorder.

Keywords

Acknowledgement

이 논문은 한국연구재단을 통한 교육부의 중점연구소지원사업(NRF-2020R1A6A1A03043528), 교육부의 기초연구사업(NRF-2020R1I1A1A01057962), 과학기술정보통신부의 기초연구사업(2019R1A2C1089515)의 연구비 지원으로 수행되었습니다.

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