Shi Ping, Liu Junwen, Du Jiahao, Yu Hongliu, Fang Fanfu
Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China.
Changhai Hospital, Naval Medical University, Shanghai, China.
Pain Pract. 2022 Feb;22(2):182-190. doi: 10.1111/papr.13076. Epub 2021 Oct 5.
As a new technology, electronic wrist-ankle acupuncture (E-WAA) combines the advantages of wrist-ankle acupuncture and transcutaneous electrical nerve stimulation, but the analgesic effect and mechanism need to be clarified. The purpose of this study was to identify the pain modulation caused by E-WAA by evaluating the response of the prefrontal cortex (PFC) from the perspective of neurophysiology.
Fifty male volunteers (age 25.00 ± 1.05 years) with trapezius myofascial pain syndrome were randomly allocated into intervention group (E-WAA treatment) or sham control group at a 1:1 ratio. An outcome evaluation system was used to induce tenderness on the Jianjing point and record the pain value. A multichannel functional near-infrared spectroscope was used to detect the PFC activation during tenderness before and after treatment to demonstrate the neuromodulation mechanism. A general linear model and t-test (p < 0.05) were used to analyze the difference in the oxyhemoglobin (HbO) concentration and pain value.
In the intervention group, the pain value of volunteers decreased significantly (p = 0.017) after E-WAA treatment, whereas there was no statistical difference (p = 0.082) in the sham group. Before treatment, the frontopolar (FP) and dorsolateral prefrontal cortex (DLPFC) were the activation areas of the PFC. The E-WAA treatment then suppressed the activation of the two areas. The HbO concentration of the FP and DLPFC changed from a sharp rise during tenderness to not changing with tenderness stimulation.
The results demonstrated that the E-WAA have a great analgesic effect. The FP and DLPFC were relative to the analgesia neuromodulation induced by the E-WAA.
电子腕踝针作为一项新技术，融合了腕踝针与经皮电刺激神经的优势，但其镇痛效果及机制尚待明确。本研究旨在从神经生理学角度，通过评估前额叶皮质（PFC）的反应来确定电子腕踝针引起的疼痛调制。
50名患有斜方肌肌筋膜疼痛综合征的男性志愿者（年龄25.00±1.05岁），以1:1的比例随机分为干预组（电子腕踝针治疗）或假手术对照组。采用结局评估系统诱发肩井穴压痛并记录疼痛值。使用多通道功能近红外光谱仪检测治疗前后压痛期间PFC的激活情况，以阐明神经调节机制。采用一般线性模型和t检验（p<0.05）分析氧合血红蛋白（HbO）浓度和疼痛值的差异。
在干预组中，电子腕踝针治疗后志愿者的疼痛值显著降低（p = 0.017），而假手术组无统计学差异（p = 0.082）。治疗前，额极（FP）和背外侧前额叶皮质（DLPFC）是PFC的激活区域。电子腕踝针治疗后抑制了这两个区域的激活。FP和DLPFC的HbO浓度从压痛时的急剧上升变为随压痛刺激无变化。
结果表明电子腕踝针具有显著的镇痛作用。FP和DLPFC与电子腕踝针诱导的镇痛神经调节有关。
