Non-invasive neuromodulation: an emerging intervention for visceral pain in gastrointestinal disorders.
Non-invasive neuromodulation: an emerging intervention for visceral pain in gastrointestinal disorders.
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DOI：
10.1186/s42234-023-00130-5
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发表时间：
2023-11-22
影响因子：
--
通讯作者：
Chen, Jiande D Z
中科院分区：
文献类型：
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作者：
Alam, Md Jahangir;Chen, Jiande D Z
胃肠道（GI）疾病，从食道延伸到肛门，是最常见的胃肠道疾病。在这些疾病中，疼痛，包括腹部和内脏疼痛，是一个主要特征，影响患者的生活质量，并对社会造成巨大的经济负担。源自肠道的疼痛信号复杂地塑造了大脑动力学。作为回应，大脑发出适当的下行信号，通过神经元抑制对疼痛做出反应。然而，由于疾病的异质性及其有限的病理生理学理解，治疗方案是最小的，往往有争议。因此，许多胃肠道疾病患者使用补充和替代疗法，如神经调节来治疗内脏疼痛。神经调节通过使用电、电磁、化学或光遗传学方法交替或调节神经活动来干预中枢、外周或自主神经系统。在这里，我们回顾了一些新兴的非侵入性神经调节方法，有希望减轻疼痛与功能性消化不良，胃轻瘫，肠易激综合征，炎症性肠病，非心源性胸痛的潜力。此外，我们解决关键方面，包括这些非侵入性神经调节方法的有效性，安全性和可行性，阐明其作用机制，并概述未来的研究方向。总之，非侵入性神经调节的新兴领域似乎是有效管理胃肠道疾病内脏疼痛的可行替代治疗途径。在线版本包含补充材料，可通过10.1186/s42234-023-00130-5获得。
Gastrointestinal (GI) disorders, which extend from the esophagus to the anus, are the most common diseases of the GI tract. Among these disorders, pain, encompassing both abdominal and visceral pain, is a predominant feature, affecting the patients’ quality of life and imposing a substantial financial burden on society. Pain signals originating from the gut intricately shape brain dynamics. In response, the brain sends appropriate descending signals to respond to pain through neuronal inhibition. However, due to the heterogeneous nature of the disease and its limited pathophysiological understanding, treatment options are minimal and often controversial. Consequently, many patients with GI disorders use complementary and alternative therapies such as neuromodulation to treat visceral pain. Neuromodulation intervenes in the central, peripheral, or autonomic nervous system by alternating or modulating nerve activity using electrical, electromagnetic, chemical, or optogenetic methodologies. Here, we review a few emerging noninvasive neuromodulation approaches with promising potential for alleviating pain associated with functional dyspepsia, gastroparesis, irritable bowel syndrome, inflammatory bowel disease, and non-cardiac chest pain. Moreover, we address critical aspects, including the efficacy, safety, and feasibility of these noninvasive neuromodulation methods, elucidate their mechanisms of action, and outline future research directions. In conclusion, the emerging field of noninvasive neuromodulation appears as a viable alternative therapeutic avenue for effectively managing visceral pain in GI disorders. The online version contains supplementary material available at 10.1186/s42234-023-00130-5.