Enhancing acupuncture treatment effect through non-invasive neuromodulation

总结 针灸是一种外周刺激技术，已被用于治疗疼痛疾病数千年。 多年来，在西方国家越来越受欢迎。然而，临床试验评估镇痛效果 针灸治疗只发现了一个温和的具体效果。经颅直流电刺激 （tDCS）是一种安全、低成本且临床上可应用的神经调节工具，其可以调节皮质兴奋性。 越来越多的证据表明，tDCS（在初级运动回）可能是一种有希望的治疗方法， 慢性疼痛进一步的研究表明，针刺和tDCS都可能通过下行疼痛起作用， 调制系统，试点研究表明，结合两者可能会产生更大的 治疗效果优于单独使用。 本研究旨在探讨针刺与针刺协同作用的脑机制， tDCS治疗。具体而言，将招募慢性腰痛（cLBP）患者并随机分配至以下组之一： 4组（每组30只，治疗1个月）：1）真针+真实的tDCS，2）假针 + 真实的tDCS，3）真针+假tDCS，和4）假针+假tDCS。我们将研究（1） 不同治疗的纵向（一个月）效应，如静息状态功能变化所示 连接性（rsFC）、脑血流量（CBF）、腰痛的临床结局和定量感觉 测试（QST）和2）这些变化之间的关联。 针灸和tDCS都是治疗慢性疼痛的有前途的方法。解释大脑 针灸、tDCS的作用机制以及两者的协同作用将有助于开发新的 疼痛管理方法和促进疼痛护理的改善。

Summary Acupuncture is a peripheral stimulation technique that has been used to treat pain disorders for thousands of years and is gaining popularity in Western countries. However, clinical trials evaluating the analgesic efficacy of acupuncture treatment have found only a modest specific effect. Transcranial direct current stimulation (tDCS) is a safe, low cost, and clinically applicable neuromodulation tool that can modulate cortical excitability. Accumulating evidence suggest that tDCS (at the primary motor gyrus) may be a promising treatment for chronic pain. Further studies showed that both acupuncture and tDCS may work through the descending pain modulation system, and pilot studies have suggested that combining the two may produce a greater therapeutic effect than each alone. In this study, we will investigate the brain mechanism of the synergistic effects of combining acupuncture and tDCS treatments. Specifically, chronic low back pain (cLBP) patients will be recruited and randomized to one of four groups (30 per group, one month of treatment): 1) verum acupuncture + real tDCS, 2) sham acupuncture + real tDCS, 3) verum acupuncture + sham tDCS, and 4) sham acupuncture + sham tDCS. We will study 1) the longitudinal (one-month) effects of different treatments as indicated by changes in resting state functional connectivity (rsFC), cerebral blood flow (CBF), clinical outcomes of low back pain, and quantitative sensory test (QST) and 2) the association between these changes. Both acupuncture and tDCS are promising therapeutic methods for chronic pain. Elucidating the brain mechanisms of acupuncture, tDCS, and the synergistic effects of the two will facilitate the development of new pain management methods and promote improvements in pain care.