Fifteen minutes of left prefrontal repetitive transcranial magnetic stimulation acutely increases thermal pain thresholds in healthy adults
Fifteen minutes of left prefrontal repetitive transcranial magnetic stimulation acutely increases thermal pain thresholds in healthy adults
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DOI：
10.1155/2007/741897
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发表时间：
2007-12-01
影响因子：
2.9
通讯作者：
George, Mark S.
中科院分区：
文献类型：
--
作者：
Borckardt, Jeffrey J.;Smith, Arthur R.;George, Mark S.
背景：运动皮质的经颅磁刺激（TMS）似乎可以改变健康成人和慢性神经性疼痛患者的痛觉。然而，越来越多的脑成像证据表明，人类的左前额叶皮层参与了疼痛抑制。目的：由于前额叶皮层可能参与下行疼痛抑制系统，本初步研究旨在探讨通过经颅磁刺激刺激左前额叶皮层是否会影响健康成人的疼痛感知。方法：20名没有抑郁症或慢性疼痛病史的健康成年人自愿参加了一项试验性研究，在左侧前额叶皮层进行15分钟重复性经颅磁刺激（rTMS） （10 Hz， 100%静息运动阈值，开2秒，关60秒，共300次脉冲）之前和之后评估热痛阈值。受试者被随机分配接受真实或虚假的经颅磁刺激，并且对条件视而不见。结果：接受真实rTMS的受试者在TMS后表现出明显的热痛阈值增加。接受假经颅磁刺激的受试者疼痛阈值没有变化。结论：左前额叶皮层的rTMS增加了健康成人的热痛阈值。本研究的结果支持了左前额叶皮层可能是TMS治疗疼痛的一个有希望的皮层靶点的观点。需要更多的研究来确定这些发现的可靠性，最大限度地发挥作用，确定效果的持续时间，并阐明可能的作用机制。
BACKGROUND: Transcranial magnetic stimulation (TMS) of the motor cortex appears to alter pain perception in healthy adults and in patients with chronic neuropathic pain. There is, however, emerging brain imaging evidence that the left prefrontal cortex is involved in pain inhibition in humans.OBJECTIVE: Because the prefrontal cortex may be involved in descending pain inhibitory systems, the present pilot study was conducted to investigate whether stimulation of the left prefrontal cortex via TMS might affect pain perception in healthy adults.METHODS: Twenty healthy adults with no history of depression or chronic pain conditions volunteered to participate in a pilot laboratory study in which thermal pain thresholds were assessed before and after 15 min of repetitive TMS (rTMS) over the left prefrontal cortex (10 Hz, 100% resting motor threshold, 2 s on, 60 s off, 300 pulses total). Subjects were randomly assigned to receive either real or sham rTMS and were blind to condition.RESULTS: Subjects who received real rTMS demonstrated a significant increase in thermal pain thresholds following TMS. Subjects receiving sham TMS experienced no change in pain threshold.CONCLUSIONS: rTMS over the left prefrontal cortex increases thermal pain thresholds in healthy adults. Results from the present study support the idea that the left prefrontal cortex may be a promising TMS cortical target for the management of pain. More research is needed to establish the reliability of these findings, maximize the effect, determine the length of effect and elucidate possible mechanisms of action.