Longitudinal effect of transcranial direct current stimulation on knee osteoarthritis patients measured by functional infrared spectroscopy: a pilot study.
Longitudinal effect of transcranial direct current stimulation on knee osteoarthritis patients measured by functional infrared spectroscopy: a pilot study.
复制标题
通过功能红外光谱测量经颅直流电刺激对膝骨关节炎患者的纵向影响：一项初步研究。
DOI：
10.1117/1.nph.7.2.025004
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发表时间：
2020
期刊：
影响因子：
5.3
通讯作者：
Ahn,Hyochol
中科院分区：
文献类型：
--
作者：
Pollonini,Luca;Miao,Hongyu;Ahn,Hyochol
意义：膝关节骨关节炎（OA）是一种常见的关节疾病，在老年人群中引起慢性疼痛和功能改变（僵硬和肿胀）。OA目前使用镇痛药治疗，尽管最近通过经颅直流电刺激（tDCS）进行神经调节作为一种安全的无副作用治疗替代方案或慢性疼痛疾病药物的补充引起了越来越多的关注。虽然许多研究表明tDCS对疼痛的行为测量具有有益的影响，但神经调节对疼痛敏感性和中枢神经系统应对的机制尚未完全了解。目的：我们旨在观察与为期两周的tDCS自我治疗方案相关的膝关节OA老年人皮质血流动力学的纵向变化。方法：采用功能性近红外光谱法（fNIRS）测量双侧运动和躯体感觉皮质的血流动力学结果：我们发现，氧合血红蛋白和脱氧血红蛋白相关的功能激活显着增加的过程中的tDCS治疗，支持的概念，tDCS产生增加皮质兴奋性。同时，临床措施的疼痛减少与tDCS治疗，暗示在一个潜在的空间分离皮质介导的疼痛感知和抑制和神经调节作用的患病率超过皮质pain processing.Conclusions：fNIRS是一种有效的方法，客观地跟踪疼痛在门诊设置，它可能被用来通知优化tDCS治疗策略，并开发创新的tDCS协议。
Significance:Knee osteoarthritis (OA) is a common joint disease causing chronic pain and functional alterations (stiffness and swelling) in the elderly population. OA is currently treated pharmacologically with analgesics, although neuromodulation via transcranial direct current stimulation (tDCS) has recently generated a growing interest as a safe side-effect free treatment alternative or a complement to medications for chronic pain conditions. Although a number of studies have shown that tDCS has a beneficial effect on behavioral measures of pain, the mechanistic action of neuromodulation on pain sensitivity and coping at the central nervous system is not well understood.Aim:We aimed at observing longitudinal changes of cortical hemodynamics in older adults with knee OA associated with a two-week-long tDCS self-treatment protocol.Approach:Hemodynamics was measured bilaterally in the motor and somatosensory cortices with functional near-infrared spectroscopy (fNIRS) in response to thermal pain induced ipsilaterally to the knee primarily affected by OA.Results:We found that both oxyhemoglobin- and deoxyhemoglobin-related functional activations significantly increased during the course of the tDCS treatment, supporting the notion that tDCS yields an increased cortical excitability. Concurrently, clinical measures of pain decreased with tDCS treatment, hinting at a potential spatial dissociation between cortically mediated pain perception and suppression and the prevalence of neuromodulatory effects over cortical pain processing.Conclusions:fNIRS is a valid method for objectively tracking pain in an ambulatory setting and it could potentially be used to inform strategies for optimized tDCS treatment and to develop innovative tDCS protocols.