Enhancing acupuncture treatment effect through non-invasive neuromodulation

摘要 针灸是一种外周刺激技术，已被用于治疗疼痛障碍数千年 多年来，它在西方国家越来越受欢迎。然而，评估止痛效果的临床试验 的针灸治疗只发现了温和的特效。经颅直流电刺激 (Tdcs)是一种安全、低成本、临床适用的神经调节工具，可以调节皮质的兴奋性。 越来越多的证据表明，tdcs(位于初级运动回)可能是一种有前途的治疗方法。 慢性疼痛。进一步的研究表明，针灸和tdcs都可能通过下行疼痛起作用。 调制系统，试点研究表明，将两者结合起来可能会产生更大的 治疗效果优于各自单独使用。 在本研究中，我们将探讨针刺与针刺协同效应的脑机制。 Tdcs处理。具体来说，慢性下腰痛(CLBP)患者将被招募并随机分配到以下一组 4组(每组30例，疗程1个月)：1)真针+真TDC，2)假针刺 3)真针+假TDC，4)假针刺+假TDC。我们将研究1) 从静息功能变化看不同治疗方法的纵向(1个月)效应 连接性(RsFC)、脑血流量(Cbf)、下腰痛的临床结果和定量感觉 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。阐明大脑 针刺、TDCs的作用机制以及两者的协同作用将促进新的 疼痛管理方法，并促进改进疼痛护理。

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.