Enhancing acupuncture treatment effect through non-invasive neuromodulation

通过无创神经调节增强针灸治疗效果

• 批准号: 9889904
• 负责人: JIAN KONG
• 金额: $ 83.04万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9889904
• 关键词: Acupuncture Therapy; Adverse effects; American College of Physicians; Amygdaloid structure; Analgesics; Anterior; Attention; Brain; Brain imaging; Brain region; Caring; Cerebrovascular Circulation; Chronic low back pain; Clinical; Clinical Trials; Cognitive; Country; Coupled; Crossover Design; Development; Dorsal; Effectiveness; Electric Stimulation; Exhibits; Far East; Guidelines; Insula of Reil; Lateral; Learning; Light; Low Back Pain; Measurement; Measures; Memory; Methods; Motor; Motor Cortex; Neurotransmitters; Outcome; Pain; Pain Disorder; Pain Management Method; Pain intensity; Pain management; Patients; Peripheral; Pilot Projects; Prefrontal Cortex; Publishing; Randomized; Research; Rest; Sensory; Somatosensory Cortex; Spin Labels; System; Techniques; Testing; Therapeutic; Therapeutic Effect; Transcutaneous Electric Nerve Stimulation; Work; active method; chronic pain; chronic pain patient; cingulate cortex; clinical application; cost; cost effectiveness; executive function; experience; imaging modality; midbrain central gray substance; neuroregulation; pain patient; pain relief; recruit; tool; treatment effect; vigilance

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.

概括 针灸是一种外围刺激技术，已用于治疗数千种疼痛障碍 多年，在西方国家越来越受欢迎。但是，评估镇痛功效的临床试验 针灸治疗仅发现了适度的特异性作用。经颅直流刺激 （TDC）是一种安全，低成本且临床适用的神经调节工具，可以调节皮质兴奋性。 积累的证据表明，TDC（在初级运动回）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TDC都可以通过降低疼痛来起作用 调制系统和试点研究表明，将两者结合起来可能产生更大的 治疗效果比单独的效果。 在这项研究中，我们将研究结合针灸和 TDC治疗。具体而言，将招募慢性下背痛（CLBP）患者并随机分为 四组（每组30，一个月的治疗）：1）Verum针灸 +真实TDC，2）假针灸 +真实的TDC，3）verum针灸 +假tdcs和4）假针刺 +假手术TDC。我们将研究1） 静息状态功能的变化所表明的不同处理的纵向（一个月）作用 连通性（RSFC），脑血流（CBF），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TDC均为慢性疼痛的有前途的治疗方法。阐明大脑 针灸，TDC和两者的协同作用的机制将有助于新的发展 疼痛管理方法并促进疼痛护理的改善。