每日前额叶重复经颅磁刺激(rTMS)治疗灼口综合征(BMS)的疗效:一项随机对照单盲研究。

The Efficacy of Daily Prefrontal Repetitive Transcranial Magnetic Stimulation (rTMS) for Burning Mouth Syndrome (BMS): A Randomized Controlled Single-blind Study.

作者信息

Umezaki Yojiro, Badran Bashar W, DeVries William H, Moss Jkeonye, Gonzales Theresa, George Mark S

机构信息

Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.

Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.

出版信息

Brain Stimul. 2016 Mar-Apr;9(2):234-42. doi: 10.1016/j.brs.2015.10.005. Epub 2015 Oct 26.

Abstract

BACKGROUND

Burning mouth syndrome (BMS) is a burning oral sensation without any corresponding abnormal findings. In some cases, BMS is refractory to pharmacologic treatments. Repetitive transcranial magnetic stimulation (rTMS) over left prefrontal cortex induces analgesic effect in both acute and chronic pain. However, its effect for BMS has not been evaluated.

OBJECTIVE

The aim of this randomized, controlled, single-blind study was to assess the efficacy of prefrontal rTMS for BMS.

METHOD

Twenty patients with BMS were recruited and randomized to receive 30,000 pulses in total at 10 Hz TMS (n = 12) or sham TMS (n = 8). We assessed the change of BMS pain condition, functional status and mood until 2 months after the beginning of treatment.

RESULTS

In the real group, the BMS pain intensity decreased 67%, and 75% of the patients reported >50% pain decrease on final assessment compared to baseline, without heavy side effects. There was significant pain reduction in subjects in the real group immediately after 1 week of treatment, whereas there was none in those in the sham group. Similar tendency was confirmed in change of functional status. Mood and the affective aspect of pain were not changed in this study.

CONCLUSION

BMS pain was significantly improved with 2 weeks of treatment of high frequency rTMS over left DLPFC compared to sham stimulation. Further study is needed to refine and improve TMS as a potential treatment of BMS.

摘要

背景

灼口综合征(BMS)是一种口腔有烧灼感但无任何相应异常表现的病症。在某些情况下,BMS对药物治疗无效。对左侧前额叶皮质进行重复经颅磁刺激(rTMS)可在急性和慢性疼痛中产生镇痛效果。然而,其对BMS的作用尚未得到评估。

目的

这项随机、对照、单盲研究的目的是评估前额叶rTMS对BMS的疗效。

方法

招募了20例BMS患者,随机分为两组,分别接受10Hz的rTMS共30000次脉冲治疗(n = 12)或假刺激(n = 8)。我们评估了治疗开始后2个月内BMS疼痛状况、功能状态和情绪的变化。

结果

在实际治疗组中,BMS疼痛强度降低了67%,75%的患者在最终评估时报告疼痛较基线水平降低了50%以上,且无严重副作用。实际治疗组患者在治疗1周后疼痛立即显著减轻,而假刺激组则无此现象。功能状态的变化也证实了类似趋势。本研究中情绪和疼痛的情感方面没有改变。

结论

与假刺激相比,对左侧背外侧前额叶皮质进行2周的高频rTMS治疗可显著改善BMS疼痛。需要进一步研究以完善和改进TMS作为BMS潜在治疗方法的效果。

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