Xiong Huan-Yu, Zheng Jie-Jiao, Wang Xue-Qiang
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
Huadong Hospital, Shanghai, China.
Front Mol Neurosci. 2022 May 26;15:888716. doi: 10.3389/fnmol.2022.888716. eCollection 2022.
As a technique that can guide brain plasticity, non-invasive brain stimulation (NIBS) has the potential to improve the treatment of chronic pain (CP) because it can interfere with ongoing brain neural activity to regulate specific neural networks related to pain management. Treatments of CP with various forms of NIBS, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), using new parameters of stimulation have achieved encouraging results. Evidence of moderate quality indicates that high-frequency rTMS of the primary motor cortex has a clear effect on neuropathic pain (NP) and fibromyalgia. However, evidence on its effectiveness regarding pain relief in other CP conditions is conflicting. Concerning tDCS, evidence of low quality supports its benefit for CP treatment. However, evidence suggesting that it exerts a small treatment effect on NP and headaches is also conflicting. In this paper, we describe the underlying principles behind these commonly used stimulation techniques; and summarize the results of randomized controlled trials, systematic reviews, and meta-analyses. Future research should focus on a better evaluation of the short-term and long-term effectiveness of all NIBS techniques and whether they decrease healthcare use, as well as on the refinement of selection criteria.
作为一种能够引导大脑可塑性的技术,非侵入性脑刺激(NIBS)有潜力改善慢性疼痛(CP)的治疗,因为它可以干扰正在进行的大脑神经活动,以调节与疼痛管理相关的特定神经网络。使用新的刺激参数,采用各种形式的NIBS(如重复经颅磁刺激(rTMS)和经颅直流电刺激(tDCS))治疗CP已取得了令人鼓舞的结果。中等质量的证据表明,对初级运动皮层进行高频rTMS对神经性疼痛(NP)和纤维肌痛有明显效果。然而,关于其在其他CP病症中缓解疼痛有效性的证据存在矛盾。关于tDCS,低质量的证据支持其对CP治疗有益。然而,表明它对NP和头痛产生较小治疗效果的证据也存在矛盾。在本文中,我们描述了这些常用刺激技术背后的基本原理;并总结了随机对照试验、系统评价和荟萃分析的结果。未来的研究应集中在更好地评估所有NIBS技术的短期和长期有效性,以及它们是否减少医疗保健使用,同时还应优化选择标准。
Front Mol Neurosci. 2022-5-26
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