Transcranial magnetic stimulation in the treatment of chronic widespread pain: a randomized controlled study.
Transcranial magnetic stimulation in the treatment of chronic widespread pain: a randomized controlled study.
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经颅磁刺激在治疗慢性广泛疼痛的治疗中：一项随机对照研究。
DOI：
10.1097/yct.0000000000000125
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Roy-Byrne P
中科院分区：
文献类型：
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作者：
Avery DH;Zarkowski P;Krashin D;Rho WK;Wajdik C;Joesch JM;Haynor DR;Buchwald D;Roy-Byrne P
我们的目标是评估经颅磁刺激 (TMS) 在治疗慢性广泛性疼痛 (CWP) 中的作用。 19 名参与者被随机分为两组：一组接受主动 TMS（N=7），另一组接受施加于左背外侧前额叶皮层的假刺激（N=11）。在假刺激期间，受试者听到的声音与接受主动治疗的人听到的声音相似，并接受头皮的主动电刺激。刺激方案包括 4 周内完成的 15 个疗程。在基线和每 5 个疗程后进行盲评估，然后在最后一次 TMS 疗程后 1 周、1 个月和 3 个月进行盲评估。主要结果变量是疼痛测量，即 Gracely Box 强度量表 (BIRS)。两组中猜测自己正在接受 TMS 的受试者比例相似。在治疗的急性期和随访阶段，TMS 组和假手术组的 BIRS 评分均较基线显着降低，具有统计学意义。然而，TMS 组和假手术组的 BIRS 评分变化没有差异。尽管之前的一些 TMS 治疗疼痛的临床研究和基础科学研究很有希望，但本研究发现 TMS 和假刺激的镇痛效果没有差异。未来的研究应该利用假条件来尝试模拟 TMS 刺激的声音和感觉。在未来的研究中应探索刺激位置和其他刺激参数。
Our objective was to assess transcranial magnetic stimulation (TMS) in the treatment of chronic widespread pain (CWP). Nineteen participants were randomized to two groups: one receiving active TMS (N=7) and another receiving sham stimulation (N=11) applied to the left dorsolateral prefrontal cortex. During sham stimulation, subjects heard a sound similar to the sound heard by those receiving the active treatment and received an active electrical stimulus to the scalp. The stimulation protocol consisted of 15 sessions completed within a 4-week period. Blind assessments were done at baseline and after each 5 sessions followed by blind assessments at 1 week, 1 month and 3 months after the last TMS sessions. The primary outcome variable was a pain measure, the Gracely Box Intensity Scale (BIRS). The percentage of subjects who guessed that they were receiving TMS was similar in the two groups. Both the TMS group and the sham group showed a statistically significant reduction in the BIRS scores from baseline during the acute phase of treatment and the follow-up phase. However, the TMS and sham groups did not differ in the change in the BIRS scores. Although some previous clinical studies and basic science studies of TMS in treating pain are promising, this study found no difference in the analgesic effect of TMS and sham stimulation. Future studies should utilize a sham condition that attempts to simulate the sound and sensation of the TMS stimulation. Stimulus location and other stimulus parameters should be explored in future studies.