Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany; TUM-Neuroimaging Center, School of Medicine, TUM, Munich, Germany.
Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany; TUM-Neuroimaging Center, School of Medicine, TUM, Munich, Germany; Center for Interdisciplinary Pain Medicine, School of Medicine, TUM, Munich, Germany.
J Pain. 2021 Oct;22(10):1256-1272. doi: 10.1016/j.jpain.2021.03.150. Epub 2021 Jun 12.
Chronic pain is a major health care problem. A better mechanistic understanding and new treatment approaches are urgently needed. In the brain, pain has been associated with neural oscillations at alpha and gamma frequencies, which can be targeted using transcranial alternating current stimulation (tACS). Thus, we investigated the potential of tACS to modulate pain and pain-related autonomic activity in an experimental model of chronic pain in 29 healthy participants. In 6 recording sessions, participants completed a tonic heat pain paradigm and simultaneously received tACS over prefrontal or somatosensory cortices at alpha or gamma frequencies or sham tACS. Concurrently, pain ratings and autonomic responses were collected. Using the present setup, tACS did not modulate pain or autonomic responses. Bayesian statistics confirmed a lack of tACS effects in most conditions. The only exception was alpha tACS over somatosensory cortex where evidence was inconclusive. Taken together, we did not find significant tACS effects on tonic experimental pain in healthy humans. Based on our present and previous findings, further studies might apply refined stimulation protocols targeting somatosensory alpha oscillations. TRIAL REGISTRATION: The study protocol was pre-registered at ClinicalTrials.gov (NCT03805854). PERSPECTIVE: Modulating brain oscillations is a promising approach for the treatment of pain. We therefore applied transcranial alternating current stimulation (tACS) to modulate experimental pain in healthy participants. However, tACS did not modulate pain, autonomic responses, or EEG oscillations. These findings help to shape future tACS studies for the treatment of pain.
慢性疼痛是一个主要的医疗保健问题。迫切需要更好的机制理解和新的治疗方法。在大脑中，疼痛与阿尔法和伽马频率的神经振荡有关，这些振荡可以通过经颅交流电刺激（tACS）来靶向。因此，我们在 29 名健康参与者的慢性疼痛实验模型中研究了 tACS 调节疼痛和与疼痛相关的自主活动的潜力。在 6 次记录会话中，参与者完成了持续热痛范式，并同时在前额叶或躯体感觉皮层上接受了阿尔法或伽马频率或假 tACS 的 tACS。同时，收集了疼痛评分和自主反应。使用本设置，tACS 不会调节疼痛或自主反应。贝叶斯统计证实，在大多数情况下，tACS 没有效果。唯一的例外是在躯体感觉皮层上的阿尔法 tACS，那里的证据不确定。总的来说，我们没有发现 tACS 对健康人类持续实验性疼痛有显著影响。基于我们目前和以前的发现，进一步的研究可能会应用针对躯体感觉阿尔法振荡的精细刺激方案。试验注册：研究方案已在 ClinicalTrials.gov 上预先注册（NCT03805854）。观点：调节大脑振荡是治疗疼痛的一种很有前途的方法。因此，我们应用经颅交流电刺激（tACS）来调节健康参与者的实验性疼痛。然而，tACS 并没有调节疼痛、自主反应或 EEG 振荡。这些发现有助于塑造未来 tACS 治疗疼痛的研究。
