Sveva Valerio, Cruciani Alessandro, Mancuso Marco, Santoro Francesca, Latorre Anna, Monticone Marco, Rocchi Lorenzo
Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, University of Rome "Sapienza", Piazzale Aldo Moro 5, 00185 Rome, Italy.
Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy.
J Pers Med. 2024 Jun 23;14(7):675. doi: 10.3390/jpm14070675.
Chronic pain poses a widespread and distressing challenge; it can be resistant to conventional therapies, often having significant side effects. Non-invasive brain stimulation (NIBS) techniques offer promising avenues for the safe and swift modulation of brain excitability. NIBS approaches for chronic pain management targeting the primary motor area have yielded variable outcomes. Recently, the cerebellum has emerged as a pivotal hub in human pain processing; however, the clinical application of cerebellar NIBS in chronic pain treatment remains limited. This review delineates the cerebellum's role in pain modulation, recent advancements in NIBS for cerebellar activity modulation, and novel biomarkers for assessing cerebellar function in humans. Despite notable progress in NIBS techniques and cerebellar activity assessment, studies targeting cerebellar NIBS for chronic pain treatment are limited in number. Nevertheless, positive outcomes in pain alleviation have been reported with cerebellar anodal transcranial direct current stimulation. Our review underscores the potential for further integration between cerebellar NIBS and non-invasive assessments of cerebellar function to advance chronic pain treatment strategies.
慢性疼痛构成了一个广泛且令人苦恼的挑战；它可能对传统疗法产生抵抗，且常常伴有显著的副作用。非侵入性脑刺激（NIBS）技术为安全、快速地调节脑兴奋性提供了有前景的途径。针对初级运动区的慢性疼痛管理的NIBS方法产生了不同的结果。最近，小脑已成为人类疼痛处理中的一个关键枢纽；然而，小脑NIBS在慢性疼痛治疗中的临床应用仍然有限。这篇综述阐述了小脑在疼痛调节中的作用、用于调节小脑活动的NIBS的最新进展，以及评估人类小脑功能的新型生物标志物。尽管NIBS技术和小脑活动评估取得了显著进展，但针对慢性疼痛治疗的小脑NIBS研究数量有限。然而，小脑阳极经颅直流电刺激已报告了在缓解疼痛方面的积极结果。我们的综述强调了小脑NIBS与小脑功能的非侵入性评估进一步整合以推进慢性疼痛治疗策略的潜力。
