Terney Daniella, Bergmann Inga, Poreisz Csaba, Chaieb Leila, Boros Klára, Nitsche Michael Andreas, Paulus Walter, Antal Andrea
Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany.
J Pain Symptom Manage. 2008 Jul;36(1):79-91. doi: 10.1016/j.jpainsymman.2007.08.014. Epub 2008 Mar 20.
Transcranial direct current stimulation (tDCS) was recently reintroduced as a tool for inducing relatively long-lasting changes in cortical excitability in focal brain regions. Anodal stimulation over the primary motor cortex enhances cortical excitability, whereas cathodal stimulation decreases it. Prior studies have shown that enhancement of D2 receptor activity by pergolide consolidates tDCS-generated excitability diminution for up to 24 hours and that cathodal stimulation of the primary motor cortex diminishes experimentally induced pain sensation and reduces the N2-P2 amplitude of laser-evoked potentials immediately poststimulation. In the present study, we investigated the effect of pergolide and cathodal tDCS over the primary motor cortex on laser-evoked potentials and acute pain perception induced with a Tm:YAG laser in a double-blind, randomized, placebo-controlled, crossover study. The amplitude changes of laser-evoked potentials and subjective pain rating scores of 12 healthy subjects were analyzed prior to and following 15 minutes cathodal tDCS combined with pergolide or placebo intake at five different time points. Our results indicate that the amplitude of the N2 component was significantly reduced following cathodal tDCS for up to two hours. Additionally, pergolide prolonged the effect of the cathodal tDCS for up to 24 hours, and a significantly lowered pain sensation was observed for up to 40 minutes. Our study is a further step toward clinical application of cathodal tDCS over the primary motor cortex using pharmacological intervention to prolong the excitability-diminishing effect on pain perception for up to 24 hours poststimulation. Furthermore, it demonstrates the potential for repetitive daily stimulation therapy for pain patients.
经颅直流电刺激（tDCS）最近作为一种在局部脑区诱导皮层兴奋性产生相对持久变化的工具被重新引入。对初级运动皮层进行阳极刺激可增强皮层兴奋性，而阴极刺激则降低皮层兴奋性。先前的研究表明，培高利特增强D2受体活性可巩固tDCS产生的兴奋性降低长达24小时，并且对初级运动皮层进行阴极刺激可减轻实验诱导的疼痛感觉，并在刺激后立即降低激光诱发电位的N2 - P2波幅。在本研究中，我们在一项双盲、随机、安慰剂对照、交叉研究中，调查了对初级运动皮层进行培高利特和阴极tDCS对激光诱发电位以及用Tm:YAG激光诱导的急性疼痛感知的影响。在五个不同时间点，对12名健康受试者在接受15分钟阴极tDCS联合培高利特或安慰剂摄入之前和之后的激光诱发电位幅度变化和主观疼痛评分进行了分析。我们的结果表明，阴极tDCS后N2成分的波幅在长达两小时内显著降低。此外，培高利特将阴极tDCS的效果延长至长达24小时，并且在长达40分钟内观察到疼痛感觉显著降低。我们的研究朝着在初级运动皮层上临床应用阴极tDCS迈出了进一步的步伐，即使用药物干预将对疼痛感知的兴奋性降低作用延长至刺激后24小时。此外，它证明了对疼痛患者进行每日重复刺激治疗的潜力。
