Transcutaneous spinal cord direct current stimulation inhibits the lower limb nociceptive flexion reflex in human beings
Transcutaneous spinal cord direct current stimulation inhibits the lower limb nociceptive flexion reflex in human beings
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DOI：
10.1016/j.pain.2010.10.041
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发表时间：
2011-02-01
期刊：
影响因子：
7.4
通讯作者：
Priori, Alberto
中科院分区：
文献类型：
--
作者：
Cogiamanian, Filippo;Vergari, Maurizio;Priori, Alberto
为了开发一种新的、无创的脊髓神经调节方法，我们评估了经皮直流电刺激是否会引起人类中枢疼痛通路的持久变化。采用双盲交叉设计，研究11名健康志愿者在胸脊髓皮肤上施加2 mA， 15 min的阳极直流电对下肢屈曲反射的影响。为了研究经皮脊髓直流电刺激（tsDCS）是否通过调节单少突触节段性反射通路的兴奋性间接作用于伤害反射，我们还评估了胫骨神经刺激后比目鱼肌的h反射大小。在我们的健康受试者中，在刺激后立即（T0）和刺激抵消后30分钟（T30），无淋巴结胸椎tsDCS使总下肢屈曲反射面积减少40.25%和46.9%。当我们分别分析两种下肢屈曲反射成分（RII触觉和RIII伤害）时，我们发现负极tsDCS诱导RIII区域显著减少，而对RII区域的影响轻微但不显著。经阳极tsDCS后，ⅲ区在T0和T30分别减少27%和28%。假性和活性tsDCS均使所有被测h反射变量保持不变。在主动刺激后，没有受试者报告有不良反应。这些结果表明，tsDCS有望作为药物和侵入性脊髓电刺激治疗疼痛的补充或替代工具。(C) 2010国际疼痛研究协会。Elsevier B.V.版权所有。
Aiming at developing a new, noninvasive approach to spinal cord neuromodulation, we evaluated whether transcutaneous direct current (DC) stimulation induces long-lasting changes in the central pain pathways in human beings. A double-blind crossover design was used to investigate the effects of anodal direct current (2 mA, 15 min) applied on the skin overlying the thoracic spinal cord on the lower-limb flexion reflex in a group of 11 healthy volunteers. To investigate whether transcutaneous spinal cord DC stimulation (tsDCS) acts indirectly on the nociceptive reflex by modulating excitability in mono-oligosynaptic segmental reflex pathways, we also evaluated the H-reflex size from soleus muscle after tibial nerve stimulation. In our healthy subjects, anodal thoracic tsDCS reduced the total lower-limb flexion reflex area by 40.25% immediately after stimulation (T0) and by 46.9% 30 min after stimulation offset (T30). When we analyzed the 2 lower-limb flexion reflex components (RII tactile and RIII nociceptive) separately, we found that anodal tsDCS induced a significant reduction in RIII area with a slight but not significant effect on RII area. After anodal tsDCS, the RIII area decreased by 27% at T0 and by 28% at T30. Both sham and active tsDCS left all the tested H-reflex variables unchanged. None of our subjects reported adverse effects after active stimulation. These results suggest that tsDCS holds promise as a tool that is complementary or alternative to drugs and invasive spinal cord electrical stimulation for managing pain. (C) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.