Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA.
Neurotherapeutics. 2024 Jan;21(1):e00297. doi: 10.1016/j.neurot.2023.10.007. Epub 2023 Dec 19.
Noninvasive brain stimulation (NIBS) techniques have demonstrated their potential for chronic pain management, yet their efficacy exhibits variability across studies. Refining stimulation targets and exploring additional targets offer a possible solution to this challenge. This study aimed to identify potential brain surface targets for NIBS in treating chronic pain disorders by integrating literature review, neuroimaging meta-analysis, and functional connectivity analysis on 90 chronic low back pain patients. Our results showed that the primary motor cortex (M1) (C3/C4, 10-20 EEG system) and prefrontal cortex (F3/F4/Fz) were the most used brain stimulation targets for chronic pain treatment according to the literature review. The bilateral precentral gyrus (M1), supplementary motor area, Rolandic operculum, and temporoparietal junction, were all identified as common potential NIBS targets through both a meta-analysis sourced from Neurosynth and functional connectivity analysis. This study presents a comprehensive summary of the current literature and refines the existing NIBS targets through a combination of imaging meta-analysis and functional connectivity analysis for chronic pain conditions. The derived coordinates (with integration of the international electroencephalography (EEG) 10/20 electrode placement system) within the above brain regions may further facilitate the localization of these targets for NIBS application. Our findings may have the potential to expand NIBS target selection beyond current clinical trials and improve chronic pain treatment.
非侵入性脑刺激 (NIBS) 技术已证明其在慢性疼痛管理中的潜力，但它们的疗效在不同研究中存在差异。针对这一挑战，细化刺激靶点并探索其他靶点可能是一种解决方案。本研究旨在通过对 90 名慢性腰痛患者的文献综述、神经影像学荟萃分析和功能连接分析，确定用于治疗慢性疼痛障碍的 NIBS 潜在脑表面靶点。我们的研究结果表明，根据文献综述，初级运动皮层（M1）（C3/C4，10-20 EEG 系统）和前额叶皮层（F3/F4/Fz）是治疗慢性疼痛最常用的脑刺激靶点。通过来自 Neurosynth 的荟萃分析和功能连接分析，双侧中央前回（M1）、辅助运动区、 Rolandic 脑盖和颞顶联合区均被确定为常见的潜在 NIBS 靶点。本研究全面总结了目前的文献，并通过结合神经影像学荟萃分析和功能连接分析，对现有的 NIBS 靶点进行了细化，以治疗慢性疼痛。上述脑区的坐标（整合国际脑电图 (EEG) 10/20 电极放置系统）可能进一步促进这些靶点在 NIBS 应用中的定位。我们的研究结果可能有潜力扩大 NIBS 靶点选择范围，超越当前临床试验，并改善慢性疼痛治疗。
