Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Denmark.
Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Denmark; Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA; Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, 21201, USA.
Neuroimage. 2019 Feb 1;186:93-102. doi: 10.1016/j.neuroimage.2018.10.076. Epub 2018 Nov 1.
Based on reciprocal connections between the dorsolateral prefrontal cortex (DLPFC) and basal-ganglia regions associated with sensorimotor cortical excitability, it was hypothesized that repetitive transcranial magnetic stimulation (rTMS) of the left DLPFC would modulate sensorimotor cortical excitability induced by muscle pain. Muscle pain was provoked by injections of nerve growth factor (end of Day-0 and Day-2) into the right extensor carpi radialis brevis (ECRB) muscle in two groups of 15 healthy participants receiving 5 daily sessions (Day-0 to Day-4) of active or sham rTMS. Muscle pain scores and pressure pain thresholds (PPTs) were collected (Day-0, Day-3, Day-5). Assessment of motor cortical excitability using TMS (mapping cortical ECRB muscle representation) and somatosensory evoked potentials (SEPs) from electrical stimulation of the right radial nerve were recorded at Day-0 and Day-5. At Day-0 versus Day-5, the sham compared to active group showed: Higher muscle pain scores and reduced PPTs (P < 0.04); decreased frontal N30 SEP (P < 0.01); increased TMS map volume (P < 0.03). These results indicate that muscle pain exerts modulatory effects on the sensorimotor cortical excitability and left DLPFC rTMS has analgesic effects and modulates pain-induced sensorimotor cortical adaptations. These findings suggest an important role of prefrontal to basal-ganglia function in sensorimotor cortical excitability and pain processing.
基于背外侧前额叶皮层（DLPFC）与与感觉运动皮层兴奋性相关的基底神经节区域之间的相互联系，假设左 DLPFC 的重复经颅磁刺激（rTMS）将调节由肌肉疼痛引起的感觉运动皮层兴奋性。在两组 15 名健康参与者中，通过向右侧伸腕短肌（ECRB）肌肉注射神经生长因子（第 0 天和第 2 天结束时）来引起肌肉疼痛，这两组参与者分别接受了 5 次每日 rTMS 治疗（第 0 天至第 4 天），分别为主动或假 rTMS。收集肌肉疼痛评分和压痛阈值（PPT）（第 0 天，第 3 天，第 5 天）。在第 0 天和第 5 天记录使用 TMS 评估运动皮层兴奋性（绘制 ECRB 肌肉皮层代表图）和通过右侧桡神经电刺激产生的体感诱发电位（SEP）。与主动组相比，第 0 天与第 5 天相比，假组显示：肌肉疼痛评分更高，PPT 降低（P < 0.04）；额部 N30 SEP 减少（P < 0.01）；TMS 图体积增加（P < 0.03）。这些结果表明，肌肉疼痛对感觉运动皮层兴奋性具有调节作用，左 DLPFC rTMS 具有镇痛作用，并调节疼痛引起的感觉运动皮层适应。这些发现表明，前额叶与基底神经节功能在感觉运动皮层兴奋性和疼痛处理中起着重要作用。
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