Investigation of central nervous system dysfunction in chronic pelvic pain using magnetic resonance spectroscopy and noninvasive brain stimulation.
Investigation of central nervous system dysfunction in chronic pelvic pain using magnetic resonance spectroscopy and noninvasive brain stimulation.
复制标题
DOI：
10.1111/papr.12202
复制
发表时间：
2015-06
期刊：
影响因子：
--
通讯作者：
Fregni F
中科院分区：
文献类型：
--
作者：
Simis M;Reidler JS;Duarte Macea D;Moreno Duarte I;Wang X;Lenkinski R;Petrozza JC;Fregni F
最近的研究表明，慢性盆腔疼痛与传入感觉输入的改变有关，导致疼痛神经回路的适应不良变化。为了更好地了解与慢性盆腔疼痛相关的中枢变化，我们使用单体素质子磁共振波谱（MRS）和经颅直流电刺激（tDCS）研究了关键疼痛相关神经回路的贡献。我们测量了慢性盆腔疼痛患者在基线和10天活动或假tDCS后4个感兴趣区域（丘脑、前扣带皮层、初级运动和枕叶皮层[对照]）的神经代谢物浓度。然后，我们将我们的结果与健康对照组中观察到的结果进行了比较，并与年龄和性别相匹配。我们观察到与假手术条件相比，主动tDCS后疼痛阈值显著增加。基线代谢物浓度与定量感觉评估之间存在相关性。慢性盆腔疼痛患者的初级运动皮层的NAA/Cr水平显着低于健康患者。tDCS可提高慢性骨盆疼痛患者的痛阈。疼痛相关神经回路的生化变化与疼痛水平相关，如通过客观疼痛测试所测量的。这些发现支持进一步研究慢性盆腔疼痛的靶向皮质神经调节干预。
Recent studies demonstrate that chronic pelvic pain is associated with altered afferent sensory input resulting in maladaptive changes in the neural circuitry of pain. To better understand the central changes associated with chronic pelvic pain we investigated the contributions of critical pain-related neural circuits using single-voxel proton magnetic resonance spectroscopy (MRS) and transcranial direct current stimulation (tDCS). We measured concentrations of neural metabolites in 4 regions of interest (thalamus, anterior cingulate cortex, primary motor, and occipital cortex [control]) at baseline and after 10 days of active or sham tDCS in patients with chronic pelvic pain.. We then compared our results to those observed in healthy controls, matched by age and gender. We observed a significant increase in pain thresholds after active tDCS compared to sham conditions. There was a correlation between metabolite concentrations at baseline and quantitative sensory assessments. Chronic pelvic pain patients had significantly lower levels of NAA/Cr in the primary motor cortex compared to healthy patients. tDCS increases pain thresholds in patients with chronic pelvic pain. Biochemical changes in pain-related neural circuits are associated with pain levels as measured by objective pain testing. These findings support the further investigation of targeted cortical neuromodulatory interventions for chronic pelvic pain.
登录
查看更多内容
影响因子：
4.9
作者：
Fayed N;Garcia-Campayo J;Magallón R;Andrés-Bergareche H;Luciano JV;Andres E;Beltrán J
通讯作者：
Beltrán J
影响因子：
3.5
作者：
Feraco, P.;Bacci, A.;Leonardi, M.
通讯作者：
Leonardi, M.
影响因子：
7.4
作者：
Peyron, R;García-Larrea, L;Laurent, B
通讯作者：
Laurent, B
影响因子：
7.4
作者：
García-Larrea, L;Peyron, R;Laurent, B
通讯作者：
Laurent, B
影响因子：
1.4
作者：
Grace, Victoria;Zondervan, Krina
通讯作者：
Zondervan, Krina