基于外周和中枢神经调控技术的镇痛研究

疼痛不仅严重影响了人们的生活质量，而且造成了巨大的社会和经济负担。非侵入性神经调控技术作为一种安全、易操作的调控手段可以避免药物镇痛所伴随的副作用，有效缓解患者疼痛。目前，经皮神经电刺激和经颅直流电刺激均已作为一种有效的调控手段应用于镇痛领域，但两者的最优刺激参数和镇痛机制尚不清晰；而经颅交流电刺激作为一种潜在的镇痛方法其镇痛效果有待进一步验证。基于此，本项目拟联合采用量表、行为任务、脑电和磁共振成像技术等多种测量手段，考察非侵入性神经调控技术的镇痛可靠性和可推广性。具体工作包括：1、评估经皮神经电刺激、经颅直流电刺激和经颅交流电刺激的镇痛效果，探索三种镇痛技术的最优刺激参数；2、研究三种技术镇痛的神经机制；3、考察组合刺激效果，开发整合性调控方案；4、开发个性化的治疗方案，检验调控方案用于缓解慢性疼痛的有效性和持续性。本项目的开展将促进神经调控技术基础研究的临床应用，有效缓解患者的痛苦。

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, which negatively impacts our lives, leading to an emotional and financial burden for patients, families, and the whole society. Due to many side effects of pain killers, it is necessary to find safe, effective, non-addictive analgesic strategies for pain management. Non-invasive neuromodulation techniques show tremendous promise in relieving pain due to its non-pharmacological and easy-to-use nature. Accumulating empirical evidence suggests that transcutaneous electrical nerve stimulation (TENS) and transcranial direct current stimulation (tDCS) are effective in reducing pain. However, the knowledge about their optimal stimulation parameters and underlying mechanisms is still limited. In addition, the analgesic effect induced by transcranial alternating current stimulation (tACS) has not been fully testified. To achieve a better understanding of the analgesic effect and neural mechanisms associated with non-invasive neuromodulation techniques, the present project examines the analgesic effect of the three neuromodulation techniques using a variety of measurements, including questionnaires, behavioral assessments, electroencephalography (EEG), and functional magnetic resonance imaging (fMRI). Specifically, we first evaluate the analgesic effect of TENS, tDCS, and tACS by investigating their optimal parameters to maximize the analgesic effect. Second, we explore the underlying neural mechanisms of TENS-, tDCS-, and tACS-induced analgesia. Third, we optimize the analgesic effect by combining the three neuromodulation techniques. Finally, we develop a personalized treatment program based on findings obtained in previous steps and further validate its analgesic effect in patients with chronic pain. In summary, this project will not only deepen our understandings of the analgesic effect associated with non-invasive neuromodulation techniques but also boost the translation of basic studies to clinical applications.