性和爆发性脊髓刺激对皮质疼痛处理的影响及其与有条件疼痛调制的相互作用
Laurien J Reinders1, Frank J P M Huygen1, Cecile C de Vos1
1Department of Anesthesiology, Center for Pain Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
概括
脊髓刺激 (SCS) 调节疼痛通路. 这项研究表明,SCS对皮质反应的影响不同,有力SCS可能会抑制上升途径,而爆发SCS在条件疼痛调制 (CPM) 中会参与下降途径.
科学领域:
- 神经科学是一个神经科学.
- 疼痛管理 疼痛管理
- 医疗器械 医疗器械
背景情况:
- 脊髓刺激 (SCS) 是慢性疼痛的关键治疗方法.
- 脑神经系统机制涉及调节上升和下降的疼痛路径.
- 有条件疼痛调制 (CPM) 评估下降疼痛通路的功能.
研究的目的:
- 通过分析疼痛刺激期间的皮质活动来研究SCS机制.
- 为了确定不同的SCS范式 (调子,爆发,假) 如何影响皮质反应.
- 评估CPM在各种SCS条件下对皮质活动的影响.
主要方法:
- 磁脑电图 (MEG) 测量了14名患有2型持续脊柱疼痛综合征的患者对电刺激的皮质反应.
- 在强化,爆发和假SCS下,在CPM前,期间和之后分析皮质活动.
- 分析包括时间域 (唤起的响应) 和时间频率域 (β事件相关同步[ERS]).
主要成果:
- 在CPM期间,疼痛评级显著降低 (p <0.05).
- 在模拟和爆发SCS下CPM期间,唤起的响应幅度下降 (p < 0.05).
- 在强化和爆发SCS下,Beta ERS功率在CPM期间下降,但不是假的SCS (p > 0.05).
结论:
- 引起和诱导的皮质反应反映了CPM期间不同的SCS机制.
- 调性SCS可能会抑制上升的横向通路输入,可能会限制CPM的抑制作用.
- 在CPM期间降低β ERS表明SCS参与下降疼痛调节通路.
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