对背外侧前额叶皮层进行非侵入性电刺激的镇痛效果:系统回顾与荟萃分析

IF 3.5 2区 医学 Q2 PSYCHIATRY Journal of Psychosomatic Research Pub Date : 2024-07-31 DOI:10.1016/j.jpsychores.2024.111868
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引用次数: 0

摘要

目的 背外侧前额叶皮层(DLPFC)与疼痛调节有关,这表明它有可能成为缓解疼痛的治疗靶点。然而,有关经颅电刺激(tES)DLPFC的研究结果各不相同,这可能是由于刺激方案或疼痛评估方法的差异造成的。本研究旨在使用荟萃分析方法评估 DLPFC-tES 的镇痛效果。在健康人和临床疼痛患者中研究了真实和虚假DLPFC-tES对痛觉的影响。结果DLPFC-tES对健康人群的疼痛结果没有显著影响,但在降低临床疼痛患者的疼痛强度评级方面表现良好(Hedges' g = -0.78, 95% CI = [-1.33, -0.24],p = 0.005)。电极位置对镇痛效果有明显影响,当阳极位于 F3,阴极位于 F4 时,镇痛效果更好。优化电极位置,尤其是对称配置,可提高疗效。这些研究结果突显了 DLPFC-tES 在临床环境中减轻感知疼痛强度的前景,同时强调了电极位置优化的重要性。
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Analgesia of noninvasive electrical stimulation of the dorsolateral prefrontal cortex: A systematic review and meta-analysis

Objective

The dorsolateral prefrontal cortex (DLPFC) is implicated in pain modulation, suggesting its potential as a therapeutic target for pain relief. However, studies on transcranial electrical stimulation (tES) over the DLPFC yielded diverse results, likely due to differences in stimulation protocols or pain assessment methods. This study aims to evaluate the analgesic effects of DLPFC-tES using a meta-analytical approach.

Methods

A meta-analysis of 29 studies involving 785 participants was conducted. The effects of genuine and sham DLPFC-tES on pain perception were examined in healthy individuals and patients with clinical pain. Subgroup analyses explored the impact of stimulation parameters and pain modalities.

Results

DLPFC-tES did not significantly affect pain outcomes in healthy populations but showed promise in reducing pain-intensity ratings in patients with clinical pain (Hedges' g = −0.78, 95% CI = [−1.33, −0.24], p = 0.005). Electrode placement significantly influenced the analgesic effect, with better results observed when the anode was at F3 and the cathode at F4.

Conclusions

DLPFC-tES holds potential as a cost-effective pain management option, particularly for clinical populations. Optimizing electrode placement, especially with an symmetrical configuration, may enhance therapeutic efficacy. These findings underscore the promise of DLPFC-tES for alleviating perceived pain intensity in clinical settings, emphasizing the importance of electrode placement optimization.

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来源期刊
Journal of Psychosomatic Research
Journal of Psychosomatic Research 医学-精神病学
CiteScore
7.40
自引率
6.40%
发文量
314
审稿时长
6.2 weeks
期刊介绍: The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.
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