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经 MRI 引导的经颅聚焦超声(tFUS)对前丘脑进行超声处理可改变健康成年人的疼痛阈值:一项双盲、假对照研究。

Sonication of the anterior thalamus with MRI-Guided transcranial focused ultrasound (tFUS) alters pain thresholds in healthy adults: A double-blind, sham-controlled study.

机构信息

Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.

Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Brain Stimul. 2020 Nov-Dec;13(6):1805-1812. doi: 10.1016/j.brs.2020.10.007. Epub 2020 Oct 24.


DOI:10.1016/j.brs.2020.10.007
PMID:33127579
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7888561/
Abstract

BACKGROUND: Transcranial focused ultrasound (tFUS) is a noninvasive brain stimulation method that may modulate deep brain structures. This study investigates whether sonication of the right anterior thalamus would modulate thermal pain thresholds in healthy individuals. METHODS: We enrolled 19 healthy individuals in this three-visit, double-blind, sham-controlled, crossover trial. Participants first underwent a structural MRI scan used solely for tFUS targeting. They then attended two identical experimental tFUS visits (counterbalanced by condition) at least one week apart. Within the MRI scanner, participants received two, 10-min sessions of either active or sham tFUS spread 10 min apart targeting the right anterior thalamus [fundamental frequency: 650 kHz, Pulse repetition frequency: 10 Hz, Pulse Width: 5 ms, Duty Cycle: 5%, Sonication Duration: 30s, Inter-Sonication Interval: 30 s, Number of Sonications: 10, ISPTA. 995 mW/cm2, ISPTA. 719 mW/cm2, Peak rarefactional pressure 0.72 MPa]. The primary outcome measure was quantitative sensory thresholding (QST), measuring sensory, pain, and tolerance thresholds to a thermal stimulus applied to the left forearm before and after right anterior thalamic tFUS. RESULTS: The right anterior thalamus was accurately sonicated in 17 of the 19 subjects. Thermal pain sensitivity was significantly attenuated after active tFUS. The pre-post x active-sham interaction was significant (F(1,245.95) = 4.03, p = .046). This interaction indicates that in the sham stimulation condition, thermal pain thresholds decreased 1.08 °C (SE = 0.28) pre-post session, but only decreased .51 °C (SE = 0.30) pre-post session in the active stimulation group. CONCLUSIONS: Two 10-min sessions of anterior thalamic tFUS induces antinociceptive effects in healthy individuals. Future studies should optimize the parameter space, dose and duration of this effect which may lead to multi-session tFUS interventions for pain disorders.

摘要

背景:经颅聚焦超声(tFUS)是一种非侵入性的脑刺激方法,可能调节深部脑结构。本研究探讨了右前丘脑的超声是否会调节健康个体的热痛阈值。

方法:我们招募了 19 名健康个体参加这项三访、双盲、假对照、交叉试验。参与者首先进行了一次仅用于 tFUS 靶向的结构 MRI 扫描。然后,他们在至少相隔一周的两次相同的实验性 tFUS 访问(通过条件平衡)中接受治疗。在 MRI 扫描仪内,参与者接受两次、每次 10 分钟的主动或假 tFUS 治疗,间隔 10 分钟。右前丘脑靶向[基频:650 kHz、脉冲重复频率:10 Hz、脉冲宽度:5 ms、占空比:5%、超声持续时间:30 s、超声间隔时间:30 s、超声次数:10 次、ISPTA. 995 mW/cm2、ISPTA. 719 mW/cm2、峰值稀疏压力 0.72 MPa]。主要结局测量是定量感觉阈值(QST),测量左前臂热刺激前后的感觉、疼痛和耐受阈值。

结果:在 19 名受试者中,有 17 名准确地对右前丘脑进行了超声治疗。主动 tFUS 后热痛敏感性显著降低。主动-假刺激前后的交互作用具有统计学意义(F(1,245.95) = 4.03,p = 0.046)。这种相互作用表明,在假刺激条件下,热痛阈值在会话前后降低了 1.08°C(SE=0.28),但在主动刺激组中仅降低了 0.51°C(SE=0.30)。

结论:两次 10 分钟的前丘脑 tFUS 治疗可诱导健康个体的镇痛作用。未来的研究应优化该效应的参数空间、剂量和持续时间,这可能导致多疗程 tFUS 干预疼痛障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7303/7888561/44962e86b7d5/nihms-1666632-f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7303/7888561/81096cecc862/nihms-1666632-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7303/7888561/1f04cfd36956/nihms-1666632-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7303/7888561/44962e86b7d5/nihms-1666632-f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7303/7888561/81096cecc862/nihms-1666632-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7303/7888561/1f04cfd36956/nihms-1666632-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7303/7888561/44962e86b7d5/nihms-1666632-f0004.jpg

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本文引用的文献

[1]
Effects of sonication parameters on transcranial focused ultrasound brain stimulation in an ovine model.

PLoS One. 2019-10-24

[2]
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Brain Stimul. 2019-7-31

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Ultrasound Neuromodulation: A Review of Results, Mechanisms and Safety.

Ultrasound Med Biol. 2019-5-18

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J Neurosurg. 2019-5-3

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Manipulation of Subcortical and Deep Cortical Activity in the Primate Brain Using Transcranial Focused Ultrasound Stimulation.

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Elife. 2019-2-12

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Increased Excitability Induced in the Primary Motor Cortex by Transcranial Ultrasound Stimulation.

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Psychiatr Clin North Am. 2018-9

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