Department of Neurological Sciences, University "La Sapienza", Viale Università 30, 00185 Rome, Italy.
Eur J Pain. 2011 Nov;15(10):1023-7. doi: 10.1016/j.ejpain.2011.04.009. Epub 2011 May 14.
Despite concerted efforts from pharmacologic research into neuropathic pain, many patients fail to achieve sufficient pain relief with medication alone. For this reason, increasing interest centres on neurostimulation techniques. We assessed whether transcutaneous spinal direct current stimulation (tsDCS) modulates conduction in ascending nociceptive spinal pathways. We measured changes induced by anodal and cathodal tsDCS over the thoracic spinal cord on face- and foot-laser evoked potentials (LEPs) and foot-cold pressor test responses in 20 healthy subjects. Whereas anodal tsDCS reduced the amplitude of the N1 and N2 components of foot-LEPs (P<0.05) neither anodal nor cathodal tsDCS changed LEPs evoked by face stimulation. Pain tolerance to the cold pressor test was significantly higher after anodal than after cathodal tsDCS (P<0.05). Conversely, no difference was found in the pain threshold or pain ratings to the cold pressor test between the two polarity conditions. Our data suggest that anodal tsDCS over the thoracic spinal cord might impair conduction in the ascending nociceptive spinal pathways, thus modulating LEPs and increasing pain tolerance in healthy subjects.
尽管在治疗神经性疼痛的药理学研究方面进行了协同努力，但许多患者仅通过药物治疗仍无法获得足够的疼痛缓解。出于这个原因，人们对神经刺激技术的兴趣日益增加。我们评估了经皮脊髓直流电刺激（tsDCS）是否调节了上行伤害性脊髓通路的传导。我们在 20 名健康受试者中测量了经胸脊髓的阳极和阴极 tsDCS 对脸部和脚部激光诱发的电位（LEP）和脚部冷加压测试反应的 N1 和 N2 成分的振幅的变化。阳极 tsDCS 降低了脚部 LEP 的 N1 和 N2 成分的振幅（P<0.05），而阳极和阴极 tsDCS 均未改变脸部刺激引起的 LEP。阳极 tsDCS 后冷加压测试的疼痛耐受能力明显高于阴极 tsDCS（P<0.05）。相反，在两种极性条件下，冷加压测试的疼痛阈值或疼痛评分没有差异。我们的数据表明，经胸脊髓的阳极 tsDCS 可能会损害上行伤害性脊髓通路的传导，从而调节 LEP 并增加健康受试者的疼痛耐受能力。
