Marchand S, Bushnell M C, Molina-Negro P, Martinez S N, Duncan G H
Centre de Recherche en Sciences Neurologiques, Université de Montréal, Montréal, Que.Canada Faculté de Médecine Dentaire, Université de Montréal, Montréal, Que.Canada Faculté de Médecine, Université de Montréal, Montréal, Que.Canada Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Que.Canada.
Pain. 1991 Jun;45(3):249-257. doi: 10.1016/0304-3959(91)90049-4.
Despite the extensive use of dorsal column stimulation (DCS) for the control of various chronic pain conditions, most clinicians report only modest success rates. Surprisingly, there has been little placebo-controlled investigation of its efficacy for altering either clinical or experimental pain perception. The current study compared the effects of DCS to placebo stimulation on clinical pain perception, perceived intensity of painful heat stimuli and visual stimuli, and the discrimination of small changes in noxious heat intensity and in light intensity. We found that DCS, but not placebo stimulation, significantly altered ratings of spontaneous clinical pain as well as those of painful cutaneous heat. In addition, heat discrimination thresholds were increased by DCS, but not placebo. On the other hand, DCS had no effect on ratings of visual stimulus intensity nor on visual discrimination, suggesting that the DCS modulation of pain perception was not due to a general change in attention. These data indicate that DCS significantly alters pain transmission in humans. Nevertheless, the relatively small reduction in clinical pain (less than 30%) must be weighed against the invasive nature of electrode implantation.
尽管背柱刺激（DCS）被广泛用于控制各种慢性疼痛状况，但大多数临床医生报告的成功率仅为中等。令人惊讶的是，几乎没有关于其改变临床或实验性疼痛感知效果的安慰剂对照研究。本研究比较了DCS与安慰剂刺激对临床疼痛感知、热痛刺激和视觉刺激的感知强度，以及对有害热强度和光强度微小变化的辨别能力的影响。我们发现，DCS而非安慰剂刺激显著改变了自发临床疼痛评分以及皮肤热痛评分。此外，DCS提高了热辨别阈值，而安慰剂则没有。另一方面，DCS对视觉刺激强度评分和视觉辨别能力没有影响，这表明DCS对疼痛感知的调节并非由于注意力的普遍改变。这些数据表明DCS显著改变了人类的疼痛传递。然而，临床疼痛相对较小的减轻（不到30%）必须与电极植入的侵入性相权衡。
