著者

野沢 出 中山 久代 霜村 真一 橋本 かおり 今村 俊一 久松 建一 村上 嘉彦

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.52, no.4, pp.577-583, 1993 (Released:2009-06-05)

参考文献数

22

---

We carried out a questionnaire. survey on orthostatic dysregulation (abbreviated OD) in 63 young female subjects aged 18-19 years. Ten of them were judged to have confirmed OD, 8 had suspected OD, and the remaining 45 were regarded as normal. Schellong test results showed some difference in three items between the confirmed OD group and normal subjects, but the positive rate of the Schellong test in itself was not significantly different among these three groups. It was our impression that a more detailed analysis of this test is needed to increase its diagnostic validity in determining OD.The Cornell Medical Index-Health Questionnaire (abbreviated CMI) which was modified for the Japanese population with emotional disturbances by Fukamachi was given to these subjects to obtain information about their underlying psychological and emotional status. According to Fukamachi's classification Type III or IV patterns, suggestive of suspicious (III) or probable (IV) neurosis were found in 5 (11.1%) of the normal subjects, in 3 (30.3%) of the subjects with confirmed OD, and in 4 (50.0%) of those with suspected OD. These data suggest a correlation between OD and emotional and/or psychogenic disturbances.Subjects with OD and patients with vertigo or dizziness who visited our clinic were noted to have similar results on CMI. This does not, however, necessarily mean that some subjects with OD are abnormal or sick, since the CMI itself is intended only as an adjunct to, and not as a substitute for, medical interviews and physical examinations.

著者

山中 敏彰

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.71, no.1, pp.47-50, 2012 (Released:2012-03-27)

参考文献数

12

著者

清水 謙祐

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:1882577X)

巻号頁・発行日

vol.72, no.2, pp.51-67, 2013 (Released:2013-06-01)

著者

坂田 阿希 中原 はるか 室伏 利久

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.67, no.1, pp.13-17, 2008 (Released:2008-05-02)

参考文献数

14

---

Intratympanic instillation of gentamicin is currently a well-established treatment for intractable vertigo in patients with Meniere's disease. There are, however, only a few reports of this therapy in patients with non-Meniere type of vertigo. We report the case of a 68-year-old woman with the lateral semicircular canal type of benign paroxysmal positional vertigo (BPPV) following right idiopathic sudden hearing loss. The patient was annoyed by the positional vertigo for one and a half years and was successfully treated by intratympanic gentamicin instillation. She had profound hearing loss on the right side and direction-changing apogeotropic positional nystagmus. Her caloric response on the right side was severely decreased (canal paresis 80%). Intratympanic gentamicin instillation therapy was undertaken (30mg/ml/day × 5 days), following which her positional vertigo was abolished. We propose that intratympanic instillation of gentamicin may also be applicable to selected patients with long-lasting BPPV.

著者

池田 卓生

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.62, no.6, pp.511-519, 2003 (Released:2009-06-05)

参考文献数

21

被引用文献数

1

---

We performed two experiments to investigate the relationship between motion sickness and active or passive posture control. Experiment 1: Coriolis stimulation evokes not only motion sickness but also nystagmus and body sway. Eight subjects were asked to execute head tilt with eyes open or eyes covered while standing on a force-platform attached to a turntable. Eye movements were recorded using an infrared CCD camera. The center of pressure was recorded simultaneously. While gaze and posture became passive conditions and motion sickness was evoked with eyes covered, the subjects could maintain active control of posture and motion sickness was not evoked with eyes open. Experiment 2: Head tilt angle while riding in a car recorded on videotapes was quantitatively evaluated by computer analysis. While head movements of passengers became unstable and motion sickness was evoked, the head of the driver always tilted in the same direction as the curve and motion sickness was not evoked. Motion sickness appeared when the head returned from the tilted position to the original position. These results suggest that spatial orientation (the perception of the spatial relationship between self and the outer world) determines whether posture control will be active or passive, and whether motion sickness will be evoked.

著者

鈴木 衞

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.73, no.2, pp.79-89, 2014-04-30 (Released:2014-06-01)

被引用文献数

2

著者

笹 征史

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.58, no.1, pp.1-8, 1999 (Released:2009-12-07)

参考文献数

7

---

Neurotransmissions between neurons and via nerves to effector organs and from the peripheral apparatus to afferent fibers are mediated by neurotransmitters. These chemicals are composed of small molecular neurotransmitters including acetylcholine, monoamines such as dopamine, norepinephrine, serotonin, histamine and amino acids (GABA, glycine, glutamate) and large molecular transmitters (peptides such as substance P and neurokinnin). These neurotransmitters are stored in vesicles incorporated within the nerve terminals and are released by exocytosis upon arrival of impulses to the terminals resulting in Ca2+ influx. The neurotransmitters bind to selective receptors and are taken up into the nerve terminals by transporters. Receptors are composed of channel types such as nicotinic, 5-HT3, GABAA, glycine and glutamate receptors and G protein-coupled types. The latter receptors (ex: muscarinic, dopaminergic receptors) with 7-fold transcrossed-amino acids are composed of two second messenger-mediated groups via cAMP and IP3/DG, which activate protein kinase A and C, respectively. Second messengers produce a variety of responses including the iron-channel mechanism in the cell. The structure-activity relationship and receptor specificity is currently an important issue in drug research. One neurotransmitter usually acts on several kinds of receptor subtypes, therefore specific subtype receptor antagonists could be developed as potential candidates of therapeutic drugs.

著者

一般社団法人日本めまい平衡医学会 診断基準化委員会 担当理事: 飯田 政弘 池園 哲郎 伊藤 彰紀 委員長:武田 憲昭 副委員長:中村 正 委員:渡辺 行雄 重野 浩一郎 鶴岡 尚志 浅井 正嗣 山本 昌彦 武井 泰彦 今井 貴夫 池田 卓生

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.74, no.2, pp.126-133, 2015-04-30 (Released:2015-06-01)

参考文献数

5

被引用文献数

1 1

著者

佐藤 豪

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.74, no.3, pp.213-217, 2015-06-30 (Released:2015-08-01)

参考文献数

13

被引用文献数

2

著者

高木 恭也 村上 力夫 伊藤 八次 五島 桂子 松原 茂規 小島 俊己 宮田 英雄 時田 喬

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.49, no.2, pp.240-248, 1990 (Released:2009-10-13)

参考文献数

26

被引用文献数

2

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To clarify the peculiarities of gait disturbances in patients with labyrinthine, cerebellar and spinal disturbances, head movements and activity of the soleus muscles were studied during walking.The upward-downward (U-D), right-left (R-L) and forward-backward (F-B) movements of the head and activities of both soleus muscles were recorded by a polygraph with the aid of a five-channel telemeter. Head movements were recorded with three accelerometers attached to a helmet that the subject wore. Muscle activities was recorded by EMG with surface electrodes. At the same time the subject's foot-floor contact sequence was measured with electric switches in the shoes. These gait data were recorded on a pen oscillograph.1) In normal subjects, head movement recording revealed regular U-D movement and F-B inclination twice in each walking cycle and regular R-L inclination once in each walking cycle. Each soleus muscle was activated at the stance phase once in each walking cycle.2) A patient with unilateral labyrinthine disorder had head movements with irregular rhythm and ampulitude. L-R inclination of the head was not related to foot contact. The soleus muscle activities increased in the swing phase and decreased in the stance phase.3) A patient with bilateral loss of labyrinthine excitability had small, indistinct head movements with no relation to foot contact or foot raising. The record of the soleus muscle activities indicated plolongation of the active time and overlap of the activities of the two sides.4) A patient with spino-cerebellar degeneration had very irregular, unequal head movements, especially excessive F-B head movement. The active time of the soleus muscles was prolonged.5) A patient with left hemiparesis due to cervical myelopathy had small, irregular U-D and F-B head movements and large, sine wave like sway in R-Lhead movements. The soleus muscle activity of the left side in the stance phase was less than that of the right side. The record of the electric foot switch indicated that the subject often missed foot raising of her left leg.

著者

國弘 幸伸 中山 明峰

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.6, pp.465-472, 2011 (Released:2012-02-01)

参考文献数

14

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Along with Epley's canalith repositioning maneuver, the Semont maneuver is also recognized as an effective physical therapy for benign paroxysmal positional vertigo. However, the details of this maneuver are not well known, presumably because of the obscurity of the original description by Semont et al. In Japan, the “Semont liberatory maneuver,” as described by Brandt, is accepted as the “original” Semont maneuver. However, the two maneuvers are not identical. The aim of this paper was to reproduce the original procedure of Semont's as presented by A. Semont himself at the 10th Nagoya Otorhinolaryngological Forum held in Nagoya, Japan, in 2006. This lecture clarified some obscure points in the original paper; however, the procedure described at the forum was not a detailed reproduction of the original Semont maneuver, but was somewhat more complicated. Also of note, Semont decisively denied the cupulolithiasis theory and explained the usefulness of his maneuver according to the canalolithiasis theory.

著者

小宮山 櫻子 中原 はるか 津田 幸子 吉村 恵理子 室伏 利久

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.72, no.6, pp.493-500, 2013-12-31 (Released:2014-02-01)

参考文献数

17

被引用文献数

2 2

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The purposes of this study was to elucidate the clinical characteristics of patients suffering from migraine-associated vertigo (MAV) including results of cervical vestibular evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP). Thirty patients diagnosed as having MAV based on the diagnostic criteria by Sakata et al. were enrolled. We performed a retrospective chart review. These patients underwent medical history taking and examinations including cVEMP, oVEMP and a caloric test. All examinations were performed during a symptom-free interval. Twenty one patients (70%) experienced rotatory vertigo, 5 patients (17%) had floating dizziness and 4 patients (13%) had both. Twenty six patients (87%) reported tinnitus and/or aural fullness unilaterally or bilaterally. Their vertigo or dizziness lasted under 60 minutes in 10 patients (34%), 1 hour to 24 hours in 14 patients (46%), and over one day in 5 patients (17%). Canal paresis in the caloric test was observed in 5 patients (17%). Concerning cVEMP, 4 of the 30 patients (13%) showed absent cVEMPs bilaterally, 2 patients (7%) showed absent cVEMPs reflexes unilaterally, and one (3%) demonstrated decreased cVEMP amplitudes unilaterally. Only one patient showed prolonged cVEMP latencies. Concerning oVEMP, 6 of the 30 patients (20%) had absent oVEMP reflexes bilaterally, 2 (7%) had absent oVEMP reflexes unilaterally, and one (3%) had decreased oVEMP amplitudes unilaterally. In 2 patients prolonged oVEMP latencies were observed. No significant correlation was observed among cVEMP, oVEMP and the caloric test. This study showed abnormal vestibular reflexes could be shown by oVEMP as well as the caloric test and cVEMP. It was suggested that a portion of those patients with MAV have abnormal otolith-ocular reflexes.

著者

福嶋 宗久 北原 糺 堀井 新 道場 隆博 大園 芳之 今井 隆介

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.73, no.1, pp.16-21, 2014-02-28 (Released:2014-04-01)

参考文献数

13

被引用文献数

1

---

We have recently encountered two cases of intractable Meniere's disease with a history of head trauma. Both patients underwent surgical treatments because conservative medical treatment had failed. As we supposed that they had developed a secondary endolymphatic hydrops associated with perilymphatic fistula, we first performed a simple mastoidectomy and opened the facial recess to carry out an exploratory tympanotomy. Next, we performed endolymphatic sac drainage and closed both oval and round windows with connective tissue whether we found an obvious fistula or not. One year-follow-up results showed complete relief from vertigo after the operation in both cases. It is suggested that relative increase in the endolymph pressure can become a cause of endolymphatic hydrops due to the decline of the perilymph pressure. In patients with Meniere's disease who have a history of trauma, we propose that it should be better to keep in mind the possibility of fistula-induced secondary hydrops.

著者

石井 正則

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.63, no.2, pp.67-80, 2004 (Released:2009-06-05)

参考文献数

36

---

Various factors are involved in the onset of motion sickness. As an investigation of one of those factors, the spatial orientation of experimental subjects was changed, and the relationship to the development of motion sickness was examined. For an objective study, it is necessary to establish an experimental model of motion sickness. Accordingly, artificial visual field information was created, and a computer capable of highspeed calculation was used to stimulate the experimental subjects with images undergoing temporal or spatial changes. Individual experimental subjects showed considerable variation in the development of motion sickness. Thus, it was important to perform the experiments on highly susceptible subjects. The results showed that, when for both time and space, the phase was asynchronized, motion sickness manifested at a high incidence. At the time motion sickness is manifested, there is always abnormal secretion of hypothalamus-pituitary-adrenal axis hormones and the development of symptoms of autonomic nervous system instability. For this reason, it can be surmised that there is involvement of emotions and the autonomic nervous system as a result of changes in spatial orientation. It can be thought that this is due to a state of asynchronization of the intrinsic information that leads to motor commands. In particular, information from an intrinsic model with unanticipated asynchronization of eye movement and head movement is important. The relationships among spatial orientation, head-eye movement, the memory process and emotion in the manifestation of motion sickness is discussed.

著者

伊保 清子 浅野 和江 村山 真弓 阿久津 二夫 長沼 英明 徳増 厚二 岡本 牧人

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.2, pp.67-76, 2011 (Released:2011-06-01)

参考文献数

13

---

Appearance of the dominant peak-frequency in body sways during standing was retrospectively investigated in patients with spinocerebellar degeneration (SCD). Subjects tested were 25 patients with SCD (16 men and 9 women, ranging in age from 25 to 80; mean 55.8±15.4 yr). The disease types comprised SCA3 (n=5), SCA 6 (n=3), MSA-C (n=12), and an unknown type (n=5). Stabilometry was performed in each patient, who was asked to stand upright with a closed stance, with eyes open and eyes closed, using Anima's stabilometer G6100. The sampling time was 50 ms (20Hz) and the correcting time was 60 s. The peak-frequency was measured based on the power spectrum using the maximum entropy method (MEM). Total locus length, envelope area and velocity-vector of movement of the center of foot-pressure were also measured.The first or main peak appeared in a low frequency range between 0.10 and 0.59Hz in most of the cases with eyes open and eyes closed. It was detected in the lateral direction in 24 patients of the total number (96.0%) and in the anterior-posterior direction in 22 patients of the total (88.0%).The body sway of a frequency of 3Hz was detected in 4 patients (16.0%). Among them, the peak in the lateral direction was observed in 2 (8.0%) with eyes open or closed (one with SCA 6 and one with an unknown disease type). The peak in the anterior-posterior direction was detected in 3 (12.0%) with eyes open or closed (one each with SCA 6, MSA-C and an unknown disease type); in these subjects, the values of the total locus length divided by envelope area were more than 40.The dominant peak-frequency of 3Hz in body sways during standing did not frequently appear in patients with SCD, but it is suggested to be one of characteristic balance disorders in the disease.

著者

高橋 正紘

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.3, pp.204-211, 2011 (Released:2011-08-01)

参考文献数

39

被引用文献数

1 2

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I have investigated lifestyles, behavior patterns, causative factors, and progression of hearing loss in many patients with Meniere's disease, and found that lack of recompense for pressure of business, patience or service is responsible for the onset or progression of the disease. Further, aerobic exercise proved very effective to stop vertigo and improve fixed hearing loss. Three years ago, I advocated a new therapy for Meniere's disease consisting of aerobic exercise and countermeasures to remove the harmful factors in daily life (aiming at good sleep, omission, and relaxation). Because the new therapy has been far more effective than any conventional therapies, we must renew the treatment concept of and therapeutic strategy for Meniere's disease. I suspect the possibility that the CNS emotional center, stimulated by lack of recompense against stress in activities of daily living, influences the hypothalamus, which in turn reduces blood flow to the inner ear, and produces endolymphatic hydrops. Aerobic exercise, together with correction of irregular or inactive lifestyles, removes unhealthy factors, improves the subject's general physical condition, and finally cures endolymphatic hydrops.

著者

伊藤 信輔 井上 望 平野 実

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.45, no.3, pp.281-283, 1986 (Released:2009-06-05)

参考文献数

7

被引用文献数

1

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Slow eye movement induced by a vestibulo-ocular reflex was enhanced or inhibited in various postures of rabbits. A tonic neck reflex functions to help pursuit eye movement in both active and passive postures.

著者

有国 富夫

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.62, no.4, pp.284-301, 2003 (Released:2009-06-05)

参考文献数

39

---

Recently, many functional areas have been identified in the parietal cortex of the brain in monkeys, and owing to this, cytoarchitectonic subdivision has been elaborated in the monkey parietal cortex. This review deals with sulcal patterns of the parietal lobe in human and monkey brains, and corticocortical connections of both neurophysiologi-cally defined regions and cytoarchitectonic areas of the parietal cortex in monkeys. The author proposes that the transverse occipital sulcus is a boundary between the parietal and occipital cortices in the human brain. A brain map of the monkey is presented. The parietal cortical areas are subdivided into somatosensory, eye movement related, hand or upper limb movement related, vestibular, and auditory areas, according to neu-rophysiologically defined functions of individual cortical areas. The somatosensory system contains areas 3a, 3b, 1, 2, 5, 7b, and SII: S1 projects to motor and premotor areas and somatosensory association areas project to premotor areas, the prefrontal, temporal, and limbic cortices, and the hippocampus. The eye movement system is composed of areas 7a, LIP, and PIP: It receives input from visual and temporal cortices and sends output to premotor areas, the prefrontal cortex, and the hippocampus. Hand movements are mediated in areas AIP, VIP, CIP, MIP, PEc, and V6A: These areas receive afferents from somatosensory areas, visual and temporal cortices and send efferents to the ventral premotor area. The vestibular functions are executed by coordination of areas 3aNV, 3aHV, 2NV, Ri, and VPS: These areas reciprocate with the cingulate cortex and insula and project to the ventral premotor area, SWA, and frontal eye field. The auditory system involves areas VIP and LIP: It receives afferents from the superior temporal sulcal cortex and sends efferents to the premotor area, frontal eye field, and prefrontal cortex.

著者

犬飼 賢也 高橋 紳一郎 肥塚 泉

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.70, no.1, pp.17-22, 2011 (Released:2011-04-01)

参考文献数

24

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Although the duration of benign paroxysmal positional vertigo (BPPV) is generally short, it can sometimes be long and intractable. We report on a case of intractable BPPV in which the duration of disease was four years. The patient was a 38-year-old woman. She had suffered from bilateral hearing loss since childhood. Since October 2005, she experienced severe vertigo whenever she turned her head. She had consulted other doctors, but the symptoms persisted. On June 20, 2007, she was referred to the Otolaryngology Department of Tachikawa General Hospital. The positional nystagmus test demonstrated apogeotropic nystagmus in a bilateral position with a duration of more than one minute. Upbeat nystagmus with a clockwise direction (from the examiner) was seen in sitting position using the Dix-Hallpike method. A pure tone audiogram showed high tone damage causing sensorineural hearing loss bilaterally. A caloric test did not show canal paresis. Magnetic resonance imaging (MRI) of the brain showed normal findings. MRI of the inner ears showed narrowing throughout the entire semicircular canal bilaterally (mainly the bilateral anterior semicircular canals). The Brandt-Daroff method induced nausea; therefore that examination method was abandoned. Habitual training advocated by St. Marianna University, the Head shaking method from Yamaguchi University, and the Non-specific training method from Toho University did not improve the nystagmus. Vestibular training by Kitazato University improved her vertiginous feeling. The direction of nystagmus changed variously during the course. The vertiginous feeling had almost disappeared in June 2009, but nystagmus persisted. We considered that cupulolithiasis in the bilateral lateral semicircular canals often shifted to canalolithiasis in various portions of the semicircular canals. Appropriate physical therapy improved the subjective symptoms.

著者

片山 容一 深谷 親

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.67, no.1, pp.65-71, 2008 (Released:2008-05-02)

参考文献数

20

---

In an attempt to control hypokinetic and hyperkinetic movement disorders, deep brain stimulation (DBS) has been developed during the last two decades by several investigators. In 1987, Benabid and his colleagues suggested the usefulness of high-frequency stimulation of the ventral intermediate nucleus of the thalamus for treating drug-resistant tremors and avoiding the adverse effects of thalamotomy. Since then, DBS has been used as an alternative to functional neurosurgery for movement disorders, and more recently, it has been applied to the treatment of epilepsy, obsessive-compulsive disorders and cluster headache, in addition to other applications in experimental models. In regard to the treatment of movement disorders, recent clinical studies have demonstrated that DBS affords great benefits in terms of improvement of the activities of daily living in patients with Parkinson's disease (PD), essential tremor, dystonia and poststroke hyperkinetic movement disorders. We have treated patients with movement disorders by DBS of the thalamic nuclei ventralis oralis (Voa/Vop) et intermedius (Vim), globus pallidus internus (GPi), and subthalamic nucleus (STN). The site of permanent electrode placement was identified using magnetic resonance imaging and multiunit extracellular recording. The implantable pulse generator was internalized after postoperative test stimulation for one week. The stimulation parameters were modified by physicians at each follow-up visit on the basis of the findings on neurological examination, as well as the patient's report concerning the activities of daily living. The advantages of DBS include reversibility and controllability of stimulation. In addition, DBS carries a smaller risk of side effects, particularly when employed bilaterally. Thalamic DBS is useful for controlling tremor that is unresponsive to medication. DBS of the STN and GPi improves the motor functions in PD patients, mainly during the off-period. Moreover, STN-DBS attenuates levodopa-induced dyskinesia through reducing the requirement of DOPA, whereas GPi-DBS directly attenuates DOPA-induced dyskinesia. In addition, GPi-DBS is very useful for controlling the symptoms of idiopatic generalized dystonia. According to reports, DBS is associated with few serious adverse effects associated with DBS. In general, the operative mortality is less than 1%. The incidences of hemorrhage are in the range of about 1-6%, and the incidences of device-related complications, such as infection or skin erosion, are in the range of 3-26%. DBS is clinically effective in well-selected patients and should be considered as a treatment option for patients with medically refractory movement disorders. Despite its clinical usefulness, the mechanism underlying the efficacy of DBS is still unclear. There is no proof currently that long-term DBS can reset neural networks or induce profound modifications of functional organization. Several researchers have proposed hypotheses concerning the mechanism underlying the efficacy of DBS, including 1) jamming of neural transmission, 2) direct inhibition of spike initiation at the level of the membrane that may be due to the activation of inhibitory terminals, 3) functional changes due to a decrease or increase in the amount of neurotransmitter released, and 4) retrograde activation of upstream neural structures. From the viewpoint of basic neuroscience, the development of DBS is intriguing. Investigation regarding the mechanism underlying the efficacy of DBS may provide clues for further clarification of various processes in the central nervous system.