Transcranial Direct Current Stimulation as a Therapeutic Tool for Chronic Pain.
Transcranial Direct Current Stimulation as a Therapeutic Tool for Chronic Pain.
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DOI：
10.1097/yct.0000000000000518
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Fregni F
中科院分区：
文献类型：
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作者：
Pinto CB;Teixeira Costa B;Duarte D;Fregni F
经颅直流电刺激（tDCS）调节自发神经元活动，可产生长期的神经可塑性变化。tDCS已用于许多治疗试验，显示出显著的临床效果，特别是当与其他行为疗法组合时。tDCS研究的一个重点领域是慢性疼痛。自从使用当前刺激参数进行慢性疼痛治疗的最初tDCS试验以来，已经发表了60多项临床试验，测试其在不同疼痛综合征中的作用。然而，随着该领域向临床应用方向发展，需要考虑有关tDCS有效性和刺激参数的几个方面。在这篇手稿中，我们回顾了tDCS治疗慢性疼痛的证据，并批判性地分析了有关其安全性、有效性以及如何在治疗环境中优化tDCS临床效果的文献。我们在三个不同的领域讨论了tDCS效应的优化：（i）刺激参数;（ii）联合治疗和（iii）受试者选择。本文旨在为未来tDCS临床试验的发展提供见解。
Transcranial direct current stimulation (tDCS) modulates spontaneous neuronal activity that can generate long-term neuroplastic changes. tDCS has been used in numerous therapeutic trials showing significant clinical effects especially when combined with other behavioral therapies. One area of intensive tDCS research is chronic pain. Since the initial tDCS trials for chronic pain treatment using current parameters of stimulation, more than 60 clinical trials have been published testing its effects in different pain syndromes. However, as the field moves in the direction of clinical application, several aspects need to be taken into consideration regarding tDCS effectiveness and parameters of stimulation. In this manuscript, we reviewed the evidence of tDCS effects for the treatment of chronic pain and critically analyzed the literature pertaining its safety, efficacy and how to optimize tDCS clinical effects in a therapeutic setting. We discuss optimization of tDCS effects in three different domains: (i) parameters of stimulation; (ii) combination therapies and (iii) subject selection. This article aims to provide insights for the development of future tDCS clinical trials.