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经左侧前额叶皮层经颅磁刺激调节疼痛感知。

Modulation of pain perception by transcranial magnetic stimulation of left prefrontal cortex.

机构信息

Dip di Biomedicine Sperimentali e Neuroscienze Cliniche (BioNeC), University of Palermo, Via G. La Loggia, 1, 90129 Palermo, Italy.

出版信息

J Headache Pain. 2011 Apr;12(2):185-91. doi: 10.1007/s10194-011-0322-8. Epub 2011 Feb 25.


DOI:10.1007/s10194-011-0322-8
PMID:21350791
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3072504/
Abstract

Evidence by functional imaging studies suggests the role of left dorsolateral prefrontal cortex (DLPFC) in the inhibitory control of nociceptive transmission system. Repetitive transcranial magnetic stimulation (rTMS) is able to modulate pain response to capsaicin. In the present study, we evaluated the effect of DLPFC activation (through rTMS) on nociceptive control in a model of capsaicin-induced pain. The study was performed on healthy subjects that underwent capsaicin application on right or left hand. Subjects judged the pain induced by capsaicin through a 0-100 VAS scale before and after 5 Hz rTMS over left and right DLPFC at 10 or 20 min after capsaicin application in two separate groups (8 subjects each). Left DLPFC-rTMS delivered either at 10 and 20 min after capsaicin application significantly decreased spontaneous pain in both hands. Right DLPFC rTMS showed no significant effect on pain measures. According to these results, stimulation of left DLPFC seems able to exert a bilateral control on pain system, supporting the critical antinociceptive role of such area. This could open new perspectives to non-invasive brain stimulation protocols of alternative target area for pain treatment.

摘要

功能影像学研究的证据表明,左背外侧前额叶皮层(DLPFC)在抑制伤害性传入系统中起作用。重复经颅磁刺激(rTMS)能够调节辣椒素引起的疼痛反应。在本研究中,我们评估了 DLPFC 激活(通过 rTMS)对辣椒素诱导疼痛模型中伤害性控制的影响。该研究在健康受试者中进行,他们的右手或左手接受了辣椒素的应用。受试者在接受辣椒素应用后 10 或 20 分钟,通过 0-100VAS 量表评估了左、右 DLPFC 处 5Hz rTMS 对疼痛的影响,分为两组(每组 8 名受试者)。在接受辣椒素应用后 10 分钟和 20 分钟时,对左侧 DLPFC 进行 rTMS 刺激可显著降低双手的自发性疼痛。右侧 DLPFC rTMS 对疼痛测量没有显著影响。根据这些结果,刺激左侧 DLPFC 似乎能够对疼痛系统产生双侧控制,支持该区域的关键抗伤害作用。这为疼痛治疗的替代目标区域的非侵入性脑刺激方案开辟了新的前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff0/3186125/10aed8c2e298/10194_2011_322_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff0/3186125/4997ffdd4cb8/10194_2011_322_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff0/3186125/e3b642587148/10194_2011_322_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff0/3186125/10aed8c2e298/10194_2011_322_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff0/3186125/4997ffdd4cb8/10194_2011_322_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff0/3186125/e3b642587148/10194_2011_322_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff0/3186125/10aed8c2e298/10194_2011_322_Fig3_HTML.jpg

相似文献

[1]
Modulation of pain perception by transcranial magnetic stimulation of left prefrontal cortex.

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[2]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) during capsaicin-induced pain: modulatory effects on motor cortex excitability.

Exp Brain Res. 2010-3-16

[2]
Prefrontal cortex modulates placebo analgesia.

Pain. 2009-10-28

[3]
Diffuse analgesic effects of unilateral repetitive transcranial magnetic stimulation (rTMS) in healthy volunteers.

Pain. 2009-10-12

[4]
A pilot study investigating the effects of fast left prefrontal rTMS on chronic neuropathic pain.

Pain Med. 2009

[5]
rTMS for suppressing neuropathic pain: a meta-analysis.

J Pain. 2009-5-23

[6]
Modulatory effects of anodal transcranial direct current stimulation on perception and pain thresholds in healthy volunteers.

Eur J Neurol. 2008-10

[7]
Unexpected reduction in migraine and psychogenic headaches following rTMS treatment for major depression: a report of two cases.

CNS Spectr. 2007-12

[8]
Fifteen minutes of left prefrontal repetitive transcranial magnetic stimulation acutely increases thermal pain thresholds in healthy adults.

Pain Res Manag. 2007

[9]
EFNS guidelines on neurostimulation therapy for neuropathic pain.

Eur J Neurol. 2007-9

[10]
Repetitive transcranial magnetic stimulation (rTMS) in experimentally induced and chronic neuropathic pain: a review.

J Pain. 2007-6

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