对于耐药性疼痛而进行的非侵入性皮质刺激
1Central Integration of Pain (NeuroPain) Lab, Lyon Centre for Neuroscience (CRNL), INSERM U1028, University Claude Bernard Lyon 1, Villeurbanne.
Current opinion in supportive and palliative care
|June 20, 2023
概括
非侵入性神经调节,如重复性经磁刺激 (rTMS) 和经直流刺激 (tDCS),显示出神经病痛缓解的希望. 虽然有效的短期,但长期的疼痛管理仍然是一个挑战.
科学领域:
- 神经科学是一个神经科学.
- 疼痛管理 疼痛管理
- 神经调节是一种神经调节.
背景情况:
- 神经调节技术越来越多地用于缓解疼痛和改善生活质量.
- 非侵入性皮质刺激,最初是为了预测侵入性技术,现在已成为一项成熟的止痛程序.
研究的目的:
- 审查目前关于疼痛管理的非侵入性神经调节技术的证据和发现.
- 评估重复性跨磁刺激 (rTMS) 和跨直流刺激 (tDCS) 在治疗疼痛中的有效性和局限性.
主要方法:
- 对14项随机,安慰剂对照高频运动皮层rTMS治疗神经病痛的试验的综述.
- 对疼痛跨直流刺激 (tDCS) 的研究进行分析,考虑其实际优势和证据限制.
主要成果:
- 高频运动皮层rTMS显示了神经性疼痛的显著止痛作用,具有短期疗效 (NNT ~2-3).
- 超直流刺激 (tDCS) 也通过改变大脑网络来影响疼痛,在成本和家庭使用方面具有优势,但需要更多高质量的研究.
- 这两种技术都优先针对异常的过度刺激性疼痛状态,M1是慢性疼痛的关键目标,通常需要重复的治疗.
结论:
- 重复性跨磁刺激 (rTMS) 和跨直流刺激 (tDCS) 为治疗慢性神经病痛提供了可行的选择.
- 优化长期疼痛缓解和确定患者特异性反应仍然是这些神经调节技术的关键挑战.
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