通过皮肤的耳垂神经神经刺激和大耳垂神经刺激都调节了慢性腰痛中脑干核的功能和结构连接性
Yuanyuan Li1, Tingting Li1, Keming Yan1
1Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
概括
通过皮肤的迷走神经刺激 (taVNS) 和更大的耳部神经刺激 (tGANS) 通过改变脑干路径,改善了慢性腰痛. 这两种方法都调节神经连接,但通过不同的电路.
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:
- 慢性腰部疼痛 (cLBP) 影响全球数百万人,需要新的治疗方法.
- 大脑干的迷走神经通路,包括核通道单身 (NTS),位点coeruleus (LC) 和raphe核 (RN),是疼痛调节的潜在目标.
- 非侵入性神经调节技术为缓解疼痛提供了有希望的途径.
研究的目的:
- 为了研究通过皮肤进行大耳道迷走神经刺激 (taVNS) 和通过皮肤进行大耳道神经刺激 (tGANS) 对患有cLBP的个体的大脑干迷走神经通路枢纽的调节效应.
- 在cLBP患者中比较受taVNS和tGANS影响的神经回路.
主要方法:
- 一项随机对照试验涉及70名cLBP患者,他们被分配给taVNS或tGANS四周.
- 休息状态功能和结构磁共振成像 (fMRI/sMRI) 用于评估功能连接性 (sFC/dFC) 和分数异构性 (FA) 的变化.
- 分析的重点是NTS,LC和RN内的种子区域.
主要成果:
- 无论是taVNS还是tGANS组都报告了显著的疼痛改善,两组之间没有显著的差异.
- taVNS调节了NTS与各种皮层/亚皮层区域 (例如,带膜皮层,感觉运动区域,乳头,胰岛,前额叶皮层) 之间的连接,LC和运动/桃体区域,以及RN和感觉/前额叶区域.
- tGANS 影响了 NTS 与 temporoparietal 结, LC 与前额叶皮层,以及 RN 与 insula/hippocampus 之间的连接. 结构变化 (FA) 支持功能连接的发现,在taVNS组中,FA和sFC之间存在显著的负相关性.
结论:
- 在cLBP患者中,taVNS和tGANS都有效调节中心迷走神经通路内的功能和结构连接.
- 这些神经调节技术影响着不同的神经回路,突出了不同的作用机制.
- 这些发现表明,在治疗慢性疼痛方面,有潜在的非侵入性脑干神经调节.
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