Huang Zhimin, Wang Ying, Yan Yongxing, Liu Ying, Chen Jielin, Liu Huili, Li Jie, Gao Zhongming, Che Xianwei
Centre for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Department of Neurology, Hangzhou Third People's Hospital, Hangzhou, China.
Neurotherapeutics. 2025 Mar;22(2):e00496. doi: 10.1016/j.neurot.2024.e00496. Epub 2024 Nov 28.
Non-invasive brain stimulation (NIBS) technology such as transcranial magnetic stimulation (TMS) represents a promising treatment for neuropathic pain. However, neural circuitries underlying analgesia remain to be established, which is largely limiting treatment responses. Using TMS and electroencephalogram co-registration (TMS-EEG), this study quantified the circuitry abnormalities in neuropathic pain and their associations with pain symptoms. A group of 21 neuropathic pain individuals and 21 healthy controls were assessed with TMS-EEG delivering to the primary motor cortex (M1). With source modelling, local current density and current propagation were analysed with significant current density (SCD) and scattering (SCS) respectively. The SCS and SCD data converged on higher activities in neuropathic pain individuals than healthy controls, within the emotional affective (perigenual anterior cingulate cortex, pgACC), sensory nociceptive (primary somatosensory cortex, S1), and the attentional cognitive (anterior insula, aINS; supracallosal anterior cingulate cortex, scACC) structures of pain. Moreover, current propagation to the pgACC was associated with lower pain-related negative emotions, while current propagation to the aINS with higher pain-related negative emotions. Using concurrent TMS-EEG, our data identified abnormal pain circuitries that could be utilised to improve treatment efficacy with brain stimulation technologies.
诸如经颅磁刺激（TMS）之类的非侵入性脑刺激（NIBS）技术是一种很有前景的神经性疼痛治疗方法。然而，镇痛作用背后的神经回路仍有待确定，这在很大程度上限制了治疗效果。本研究使用TMS与脑电图同步记录（TMS-EEG）技术，对神经性疼痛中的神经回路异常及其与疼痛症状的关联进行了量化。对21名神经性疼痛患者和21名健康对照者进行了TMS-EEG评估，刺激部位为初级运动皮层（M1）。通过源模型，分别用显著电流密度（SCD）和散射（SCS）分析了局部电流密度和电流传播情况。SCS和SCD数据显示，在疼痛的情感（膝周前扣带回皮层，pgACC）、感觉伤害性（初级躯体感觉皮层，S1）和注意力认知（前岛叶，aINS；胼胝体上扣带回皮层，scACC）结构中，神经性疼痛患者的活动高于健康对照者。此外，电流向pgACC的传播与较低的疼痛相关负面情绪有关，而电流向aINS的传播与较高的疼痛相关负面情绪有关。通过同步TMS-EEG，我们的数据确定了异常的疼痛神经回路，可利用这些回路来提高脑刺激技术的治疗效果。
