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脊髓损伤后慢性神经性疼痛的经颅直流电刺激的可行性和效果的初步研究。

Pilot study of feasibility and effect of anodal transcutaneous spinal direct current stimulation on chronic neuropathic pain after spinal cord injury.

机构信息

Department of Rehabilitation Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.

出版信息

Spinal Cord. 2019 Jun;57(6):461-470. doi: 10.1038/s41393-019-0244-x. Epub 2019 Jan 30.

Abstract

STUDY DESIGN

A single-blind crossover study.

OBJECTIVES

This study aimed to evaluate neuropathic pain in persons with spinal cord injury (SCI) after the application of transcutaneous spinal direct current stimulation (tsDCS).

SETTING

Outpatient Clinic of the Rehabilitation Department, Seoul National University Hospital.

METHODS

The effect of single sessions of both anodal and sham tsDCS (2 mA, 20 min) on chronic neuropathic pain in ten volunteers with complete motor cervical SCI was assessed. The active electrode was placed over the spinal process of the tenth thoracic vertebra and the reference electrode, at the top of the head. Pre- to post-tsDCS intervention changes in pain intensity (numeric rating scale, NRS), patient global assessment, and present pain intensity (PPI) were assessed before and after the tsDCS session (immediately post stimulation, and at 1 and 2 h post stimulation).

RESULTS

All participants underwent the stimulation procedure without dropout. Our results showed no significant pre- to post-treatment difference in pain intensity between the active and sham tsDCS groups. Only in the sham tsDCS stimulation, NRS and PPI scores were reduced after the stimulation session. Furthermore, in the mixed effect model analysis, the response in the second period appeared to be more favorable.

CONCLUSION

The results suggest that a single session of anodal tsDCS with the montage used in this study is feasible but does not have a significant analgesic effect in individuals with chronic cervical SCI.

SPONSORSHIP

The study was funded by Seoul National University Hospital (No. 0420160470) and Korea Workers' Compensation & Welfare Service.

摘要

研究设计

单盲交叉研究。

目的

本研究旨在评估经皮脊髓直流电刺激(tsDCS)应用于脊髓损伤(SCI)患者后的神经性疼痛。

设置

首尔国立大学医院康复科门诊。

方法

评估单次阳极和假 tsDCS(2 mA,20 分钟)对 10 名完全运动性颈 SCI 志愿者慢性神经性疼痛的影响。将活性电极放置在第十胸椎的棘突上,参考电极放置在头顶。在 tsDCS 治疗前后(刺激后即刻、刺激后 1 小时和 2 小时),使用数字评分量表(NRS)、患者总体评估和目前疼痛强度(PPI)评估 tsDCS 干预前后疼痛强度的变化。

结果

所有参与者均完成了刺激程序,无脱落。我们的结果显示,在活性 tsDCS 和假 tsDCS 组之间,疼痛强度在治疗前后没有显著差异。只有在假 tsDCS 刺激中,NRS 和 PPI 评分在刺激后降低。此外,在混合效应模型分析中,第二期的反应似乎更为有利。

结论

结果表明,使用本研究中使用的方案进行单次阳极 tsDCS 是可行的,但对慢性颈 SCI 个体没有明显的镇痛作用。

赞助

本研究由首尔国立大学医院(No. 0420160470)和韩国工人补偿和福利服务机构资助。

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