Palm Ulrich, Chalah Moussa A, Padberg Frank, Al-Ani Tarik, Abdellaoui Mohamed, Sorel Marc, Dimitri Dalia, Créange Alain, Lefaucheur Jean-Pascal, Ayache Samar S
Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France.
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University Munich, Munich, Germany.
Restor Neurol Neurosci. 2016;34(2):189-99. doi: 10.3233/RNN-150557.
Pain and cognitive impairment are frequent symptoms in patients with multiple sclerosis (MS). Neglecting experimental pain and paying attention to demanding tasks is reported to decrease the pain intensity. Little is known about the interaction between chronic neuropathic pain and attention disorders in MS. Recently, transcranial direct current stimulation (tDCS) was used to modulate various cognitive and motor symptoms in MS. We aimed to study the effects of transcranial random noise stimulation (tRNS), a form of transcranial electric stimulation, over the left dorsolateral prefrontal cortex (DLPFC) on attention and neuropathic pain in MS patients.
16 MS patients were included in a randomized, sham-controlled, cross-over study. Each patient randomly received two tRNS blocks, separated by three weeks of washout interval. Each block consisted of three consecutive daily sessions of either active or sham tRNS. The patients were evaluated for pain, attention and mood and further underwent an electrophysiological evaluation.
Compared to sham, tRNS showed a trend to decrease the N2-P2 amplitudes of pain related evoked potentials and improve pain ratings. Attention performance and mood scales did not change after stimulations.
This study suggests the role of tRNS in pain modulation, which could have been more evident with longer stimulation protocols.
疼痛和认知障碍是多发性硬化症(MS)患者常见的症状。据报道,忽视实验性疼痛并专注于要求较高的任务可降低疼痛强度。关于MS患者慢性神经性疼痛与注意力障碍之间的相互作用知之甚少。最近,经颅直流电刺激(tDCS)被用于调节MS的各种认知和运动症状。我们旨在研究经颅随机噪声刺激(tRNS),一种经颅电刺激形式,作用于左侧背外侧前额叶皮层(DLPFC)对MS患者注意力和神经性疼痛的影响。
16例MS患者纳入一项随机、假对照、交叉研究。每位患者随机接受两个tRNS疗程,间隔三周洗脱期。每个疗程包括连续三天的主动或假tRNS治疗。对患者进行疼痛、注意力和情绪评估,并进一步进行电生理评估。
与假刺激相比,tRNS显示出降低疼痛相关诱发电位N2 - P2波幅并改善疼痛评分的趋势。刺激后注意力表现和情绪量表未发生变化。
本研究表明tRNS在疼痛调节中的作用,若采用更长的刺激方案可能会更明显。