Use of Repetitive Transcranial Magnetic Stimulation to Augment Hypnotic Analgesia

使用重复经颅磁刺激增强催眠镇痛

• 批准号: 9206670
• 负责人: David Spiegel
• 金额: $ 73.2万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-15 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9206670
• 关键词: Absence of pain sensation; Adverse effects; Affect; Analgesics; Anterior; Base of the Brain; Behavioral; Biological Neural Networks; Brain; Caring; Complementary Medicine; Conflict (Psychology); Data; Disease; Dorsal; Esthesia; Fatigue; Fibromyalgia; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Hypnosis; Hypnotherapy; Individual; Insula of Reil; Integrative Medicine; Intervention; Laboratories; Left; Life; Magnetic Resonance Imaging; Mainstreaming; Measures; Mediating; Medical; Methodology; Minority; Modality; Modeling; Pain; Pain Threshold; Pain management; Participant; Perception; Persons; Physiology; Play; Predisposition; Prefrontal Cortex; Psychotherapy; Randomized; Regulation; Research Personnel; Role; Scanning; Sleep; Somatosensory Cortex; Stimulus; Suggestion; Syndrome; System; Techniques; abstracting; base; chronic pain; cingulate cortex; cognitive control; cognitive function; design; fibromyalgia pain; hypnotic; intervention effect; neural circuit; neuroimaging; neuromechanism; neuroregulation; neurotechnology; novel; prevent; psychologic; relating to nervous system; repetitive transcranial magnetic stimulation; response; statistics; trait

Project Summary/Abstract Integrative medicine is, by definition, designed to combine mainstream scientific medical care with the best of practices that have been demonstrated to enhance our ability to prevent or live better with illness. Both rTMS and hypnosis have proven ability to reduce pain. Our aim is to integrate recent functional imaging data regarding hypnosis with that associated with the neural effects of repetitive transcranial magnetic stimulation (rTMS) in the treatment of fibromyalgia. Fibromyalgia is a poorly understood but common disorder characterized by the combination of widespread pain, fatigue, and sleep disruption. Our plan is to understand the brain mechanism of augmenting hypnosis and hypnotic analgesia with rTMS. We propose to identify 90 moderately hypnotizable subjects with fibromyalgia syndrome and measure their response to hypnosis, standardized pain stimuli and rTMS in the fMRI scanner before and during rTMS- augmented hypnosis and hypnotic analgesia. We will randomly assign subjects to receive either active DLPFC rTMS or sham rTMS augmentation so that we can compare results. We will have two scan sessions for each subject, one in which they receive hypnosis session where they receive control scan, control scan + hypnosis, rTMS, control scan + rTMS, and rTMS-augmented hypnosis and the other is the hypnotic analgesia session where the participant receives control scan, control scan + pain thresholds, rTMS, post rTMS scan, and rTMS-augmented hypnotic analgesia. We have three specific aims: 1) Understand the effect and neural basis of rTMS-augmentation of hypnotizability; 2) understand the effect of rTMS on hypnotizability and depth of hypnosis; 3) understand the effect and brain basis of combining hypnotic analgesia with rTMS, and 4) compare the condition of stimulation (active versus sham) with the subjective pain reduction. This approach will establish both common ground and differences between hypnotic and neuromodulatory pain relief and the potential for combining these two approaches, thereby integrating traditional and modern biomedical means of effectively treating pain. The goal is to provide a scientific basis for augmenting both approaches by combining them, thereby providing better analgesia with fewer side effects, while enhancing the ability to manage pain.

项目总结/摘要 从定义上讲，中西医结合的目的是将联合收割机主流科学 医疗保健与最佳实践已被证明，以提高我们的 有能力预防或更好地与疾病相处。经颅磁刺激和催眠都被证明 来减轻疼痛我们的目的是整合最近的功能成像数据有关催眠 与重复经颅磁刺激的神经效应相关 （rTMS）治疗纤维肌痛。纤维肌痛是一种知之甚少， 一种常见的疾病，其特征是广泛的疼痛、疲劳和 睡眠中断我们的计划是了解增强催眠的大脑机制 和rTMS催眠镇痛。我们建议识别90个中度催眠 受试者患有纤维肌痛综合征，并测量他们对催眠的反应， 在rTMS之前和期间，在fMRI扫描仪中进行标准化疼痛刺激和rTMS- 增强催眠和催眠镇痛。我们将随机分配受试者 接受主动DLPFC rTMS或假rTMS增强，以便我们可以比较 结果我们将对每个受试者进行两次扫描，其中一次是接受 催眠阶段，他们接受控制扫描，控制扫描+催眠，rTMS， 控制扫描+ rTMS和rTMS增强催眠，另一种是催眠剂 镇痛会议，参与者接受控制扫描，控制扫描+疼痛 阈值、rTMS、rTMS扫描后和rTMS增强的催眠镇痛。我们有 三个具体目标：1）了解rTMS增强的效果和神经基础， 催眠能力; 2）了解rTMS对催眠能力和深度的影响 3）了解催眠镇痛与 rTMS，和4）比较刺激条件（活性与假手术）与 主观疼痛减轻。这种做法将建立共同基础， 催眠和神经调节性疼痛缓解之间的差异以及 结合这两种方法，从而整合传统和现代生物医学 有效治疗疼痛的方法。目标是为增强 两种方法相结合，从而提供更好的镇痛， 效果，同时增强管理疼痛的能力。