1 Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China.
2 Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, New York, NY, USA.
Mol Pain. 2019 Jan-Dec;15:1744806919845739. doi: 10.1177/1744806919845739.
Effective pharmacological treatment options for chronic pain remain very limited, and continued reliance on opioid analgesics has contributed to an epidemic in the United States. On the other hand, nonpharmacologic neuromodulatory interventions provide a promising avenue for relief of chronic pain without the complications of dependence and addiction. An especially attractive neuromodulation strategy is to optimize endogenous pain regulatory circuits. The prefrontal cortex is known to provide top-down control of pain, and hence neuromodulation methods that selectively enhance the activities in this brain region during pain episodes have the potential to provide analgesia. In this study, we designed a low-frequency (2 Hz) electrical stimulation protocol to provide temporally and spatially specific enhancement of the prefrontal control of pain in rats. We showed that low-frequency electrical stimulation of the prelimbic region of the prefrontal cortex relieved both sensory and affective responses to acute pain in naive rats. Furthermore, we found that low-frequency electrical stimulation of the prefrontal cortex also attenuated mechanical allodynia in a rat model of chronic pain. Together, our findings demonstrated that low-frequency electrical stimulation of the prefrontal cortex represents a promising new method of neuromodulation to inhibit pain.
有效的慢性疼痛治疗药物选择仍然非常有限，而对阿片类镇痛药的持续依赖导致了美国的一场流行。另一方面，非药物神经调节干预为缓解慢性疼痛提供了一个有希望的途径，而不会产生依赖和成瘾的并发症。一种特别有吸引力的神经调节策略是优化内源性疼痛调节回路。已知前额皮质提供对疼痛的自上而下的控制，因此，在疼痛发作期间选择性增强该脑区域活动的神经调节方法有可能提供镇痛作用。在这项研究中，我们设计了一种低频（2 Hz）电刺激方案，以提供对大鼠疼痛的前额叶控制的时间和空间特异性增强。我们表明，对前额叶皮质的额前区进行低频电刺激可缓解急性疼痛的感觉和情感反应。此外，我们发现，对前额皮质的低频电刺激也减轻了慢性疼痛大鼠模型中的机械性痛觉过敏。总之，我们的研究结果表明，前额皮质的低频电刺激代表了一种有前途的新的神经调节方法，可以抑制疼痛。
