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 针灸是一种外周刺激技术，已被用于治疗疼痛疾病数千人 多年来，在西方国家越来越受欢迎。然而，评估镇痛功效的临床试验 针灸治疗的效果仅有限。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，可以调节皮质兴奋性。 越来越多的证据表明，经颅直流电刺激（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 tDCS 都可以缓解下行疼痛 调制系统和试点研究表明，将两者结合起来可能会产生更大的效果 治疗效果优于单独使用。 在本研究中，我们将探讨针灸与针灸相结合协同作用的大脑机制。 经颅直流电刺激 (tDCS) 治疗。具体来说，慢性腰痛 (cLBP) 患者将被招募并随机分配到以下之一： 四组（每组 30 例，治疗一个月）：1）真针灸 + 真实 tDCS，2）假针灸 + 真实 tDCS，3) 真针灸 + 假 tDCS，以及 4) 假针灸 + 假 tDCS。我们将学习1) 通过静息状态功能的变化表明不同治疗的纵向（一个月）效应 连接性 (rsFC)、脑血流量 (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 tDCS 都是治疗慢性疼痛的有前景的方法。阐明大脑 针灸、经颅直流电刺激（tDCS）的机制以及两者的协同效应将促进新疗法的开发 疼痛管理方法并促进疼痛护理的改进。