tDCS-induced analgesia and electrical fields in pain-related neural networks in chronic migraine.
tDCS-induced analgesia and electrical fields in pain-related neural networks in chronic migraine.
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DOI：
10.1111/j.1526-4610.2012.02141.x
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发表时间：
2012-09
期刊：
影响因子：
5
通讯作者：
Fregni F
中科院分区：
文献类型：
--
作者：
Dasilva AF;Mendonca ME;Zaghi S;Lopes M;Dossantos MF;Spierings EL;Bajwa Z;Datta A;Bikson M;Fregni F
我们在一项假对照试验中研究了经颅直流电刺激（tDCS）对慢性偏头痛患者初级运动皮层的镇痛作用。此外，使用高分辨率tDCS计算模型，我们分析了通过与疼痛感知和调制相关的大脑区域的电流（电场）。13例慢性偏头痛患者随机接受10次主动或假tDCS治疗，每次20分钟，2 mA，持续4周。在基线、治疗和随访期间收集数据。对于tDCS计算分析，我们采用了一种高分辨率的个性化模型，结合了对感兴趣的皮质和皮质下结构的准确分割。对于主要结果（疼痛强度）和偏头痛发作的持续时间（ANOVA，两种分析的P <0.05），存在显著的相互作用项（时间vs组）。事后分析显示，仅活性tDCS组在随访期间有显著改善。我们的计算模型研究预测了与偏头痛病理生理学相关的多个皮质和皮质下区域的电流。不仅在目标皮层区域，而且在丘脑、扣带皮层、丘脑和脑干区域中产生显著的电场。我们的研究结果提供了初步证据，慢性偏头痛患者对初级运动皮层的阳极tDCS有积极的，但延迟的反应。这些效应可能与疼痛相关的皮层和皮层下区域中诱导的电流有关。
We investigated in a sham-controlled trial the analgesic effects of a 4-week treatment of transcranial direct current stimulation (tDCS) over the primary motor cortex in chronic migraine. In addition, using a high-resolution tDCS computational model, we analyzed the current flow (electric field) through brain regions associated with pain perception and modulation. Thirteen patients with chronic migraine were randomized to receive 10 sessions of active or sham tDCS for 20 minutes with 2 mA over 4 weeks. Data were collected during baseline, treatment and follow-up. For the tDCS computational analysis, we adapted a high-resolution individualized model incorporating accurate segmentation of cortical and subcortical structures of interest. There was a significant interaction term (time vs group) for the main outcome (pain intensity) and for the length of migraine episodes (ANOVA, P < .05 for both analyses). Post-hoc analysis showed a significant improvement in the follow-up period for the active tDCS group only. Our computational modeling studies predicted electric current flow in multiple cortical and subcortical regions associated with migraine pathophysiology. Significant electric fields were generated, not only in targeted cortical regions but also in the insula, cingulate cortex, thalamus, and brainstem regions. Our findings give preliminary evidence that patients with chronic migraine have a positive, but delayed, response to anodal tDCS of the primary motor cortex. These effects may be related to electrical currents induced in pain-related cortical and subcortical regions.
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DOI：
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发表时间：
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影响因子：
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