Neuromuscular DiseasesNeuromuscular DiseasesНервно-мышечные болезни2222-87212413-0443Publishing House ABV Press68110.17650/2222-8721-2025-15-4-30-40LECTURES AND REVIEWSЛЕКЦИИ И ОБЗОРЫReview ArticleQuadripulse stimulation – a promising patterned repetitive transcranial magnetic stimulation protocolКвадрипалсная стимуляция – перспективный протокол паттерновой ритмической транскраниальной магнитной стимуляцииhttps://orcid.org/0000-0003-0716-3737BakulinIlya S.БакулинИлья Сергеевич
Russian Federation
bakulin@neurology.ruhttps://orcid.org/0009-0000-3653-2736RelinaA. R.РелинаА. Р.
Russian Federation
bakulin@neurology.ruhttps://orcid.org/0000-0003-1841-1177PoydashevaA. G.ПойдашеваА. Г.
Russian Federation
bakulin@neurology.ruhttps://orcid.org/0000-0001-8544-3107ZabirovaA. Kh.ЗабироваА. Х.
Russian Federation
bakulin@neurology.ruhttps://orcid.org/0000-0002-9267-8315LagodaD. Yu.ЛагодаД. Ю.
Russian Federation
bakulin@neurology.ruhttps://orcid.org/0000-0003-3956-6362SuponevaN. A.СупоневаН. А.
Russian Federation
bakulin@neurology.ruhttps://orcid.org/0000-0002-6338-0392PiradovM. A.ПирадовМ. А.
Russian Federation
bakulin@neurology.ruRussian Center of Neurology and NeurosciencesФГБНУ «Российский центр неврологии и нейронаук»0603202615430400503202605032026Copyright ©; 2025, Bakulin I.S., Relina A.R., Poydasheva A.G., Zabirova A.K., Lagoda D.Y., Suponeva N.A., Piradov M.A.Copyright ©; 2025, Бакулин И.С., Релина А.Р., Пойдашева А.Г., Забирова А.Х., Лагода Д.Ю., Супонева Н.А., Пирадов М.А.2025Bakulin I.S., Relina A.R., Poydasheva A.G., Zabirova A.K., Lagoda D.Y., Suponeva N.A., Piradov M.A.Бакулин И.С., Релина А.Р., Пойдашева А.Г., Забирова А.Х., Лагода Д.Ю., Супонева Н.А., Пирадов М.А.https://creativecommons.org/licenses/by/4.0https://nmb.abvpress.ru/jour/article/view/681

Quadripulse stimulation (QPS) is a relatively new and highly promising repetitive transcranial magnetic stimulation protocol. QPS is based on the application of bursts, consisting of 4 monophasic stimuli with a very short interstimulus interval (5 or 50 ms, QPS 5 and QPS50, respectively), which are repeated every 5 seconds. Long-term neuromodulating effects of QPS protocols are bi-directional depending on interstimulus interval: QPS5 increases the excitability of motor cortex while QPS50 decreases it. The main advantage of QPS protocols is a high reproducibility of their effects, which exceeds that of other repetitive transcranial magnetic stimulation protocols. This review discusses the physiological effects and possible mechanisms for inducing neuroplasticity by QPS protocols. Special attention is paid to QPS application in clinical practice both for therapeutic neuromodulation and development of new biomarkers of functional brain state. Available QPS safety data are provided and previous works limitations as well as directions for further studies are analyzed.

Квадрипалсная стимуляция (quadripulse stimulation, QPS) – относительно новый и крайне перспективный протокол ритмической транскраниальной магнитной стимуляции. QPS основана на применении повторяемых каждые 5 с серий из 4 монофазных стимулов с очень коротким межстимульным интервалом (5 или 50 мс, QPS5 и QPS50 соответственно). Протоколы QPS оказывают двунаправленный (в зависимости от межстимульного интервала) долговременный нейромодулирующий эффект на возбудимость моторной коры: QPS5 ее увеличивает, а QPS50 – снижает. Наиболее важным преимуществом протоколов QPS является высокая воспроизводимость эффектов, превышающая таковую для других протоколов ритмической транскраниальной магнитной стимуляции. В обзорной статье обсуждаются физиологические эффекты и потенциальные механизмы индукции нейропластичности при проведении QPS. Особое внимание уделяется потенциальным направлениям клинического применения QPS для терапевтической нейромодуляции и разработки новых биомаркеров функционального состояния мозга. Приводятся полученные данные о безопасности QPS, анализируются ограничения проведенных работ и направления будущих исследований.

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