Ehsani Fatemeh, Hafez Yousefi Mohaddeseh Sadat, Jafarzadeh Abbas, Zoghi Maryam, Jaberzadeh Shapour
Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran.
Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran 5166614711, Iran.
Brain Sci. 2023 Sep 28;13(10):1381. doi: 10.3390/brainsci13101381.
Many studies have shown that low back pain (LBP) is associated with psychosomatic symptoms which may lead to brain changes. This study aimed to investigate the effect of the concurrent application of cognitive behavioral therapy (CBT) and transcranial direct electrical stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on fear of pain, fear of movement, and disability in patients with nonspecific LBP. This study was performed on 45 LBP patients (23 women, 22 men; mean age 33.00 ± 1.77 years) in three groups: experimental (2 mA cathodal tDCS (c-tDCS)), sham (c-tDCS turned off after 30 s), and control (only received CBT). In all groups, CBT was conducted for 20 min per session, with two sessions per week for four weeks. Fear of pain, fear of movement, and disability were evaluated using questionnaires at baseline, immediately after, and one month after completion of interventions. Results indicated that all three different types of intervention could significantly reduce fear and disability immediately after intervention ( > 0.05). However, improvement in the experimental group was significantly higher than in the other groups immediately after and at the one-month follow-up after interventions ( < 0.05). DLPFC c-tDCS can prime the immediate effects of CBT and also the lasting effects on the reduction in the fear of pain, fear of movement, and disability in LBP patients.
许多研究表明，腰痛（LBP）与心身症状相关，这可能会导致大脑发生变化。本研究旨在探讨认知行为疗法（CBT）和经颅直流电刺激（tDCS）同时作用于左侧背外侧前额叶皮质（DLPFC）对非特异性LBP患者疼痛恐惧、运动恐惧和残疾状况的影响。本研究对45名LBP患者（23名女性，22名男性；平均年龄33.00±1.77岁）进行了分组研究：实验组（2 mA阴极tDCS（c-tDCS））、假手术组（30秒后关闭c-tDCS）和对照组（仅接受CBT）。所有组中，CBT每次进行20分钟，每周两次，共四周。在基线、干预结束后即刻以及干预结束后一个月，使用问卷对疼痛恐惧、运动恐惧和残疾状况进行评估。结果表明，所有三种不同类型的干预在干预后即刻均能显著降低恐惧和残疾程度（>0.05）。然而，在干预后即刻以及干预后一个月的随访中，实验组的改善情况显著高于其他组（<0.05）。DLPFC的c-tDCS可以增强CBT的即刻效果，以及对降低LBP患者疼痛恐惧、运动恐惧和残疾状况的持久效果。
