{"title":"经颅和脊髓联合直流电刺激治疗慢性头痛:一种新型干预措施的可行性和安全性试验","authors":"Ghufran Alhassani B.Med.Sc (Hons) , Julia Treleaven PhD , Siobhan S.M. Schabrun PhD","doi":"10.1016/j.hkpj.2016.11.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Chronic primary headache disorders are associated with frequent, severe pain and significant functional impairment, with treatment remaining challenging.</p></div><div><h3>Objective</h3><p>We examined the feasibility and safety of a novel brain [transcranial direct current stimulation (tDCS)] and spinal cord stimulation [trans-spinal cord direct current stimulation (tsDCS)] treatment in chronic headache.</p></div><div><h3>Methods</h3><p>Nine participants (3 males; aged, 40<!--> <!-->±<!--> <!-->15 years) suffering from chronic daily headache, chronic tension-type headache, or chronic migraine received the combined brain and spinal cord intervention for 5 consecutive days. Stimulation was applied for a total of 40 minutes (20 minutes of tDCS followed by 20 minutes of tsDCS) at 1 mA. Pain sensitivity and headache symptoms (frequency, severity, duration, and medications recorded via a headache diary, 4 weeks before and after treatment) were assessed.</p></div><div><h3>Results</h3><p>The treatment was safe, feasible, and well tolerated. Headache frequency was reduced following the treatment (<em>p</em> <!-->=<!--> <!-->0.026) in chronic tension-type headache and chronic migraine, but not in chronic daily headache. Headache severity was reduced immediately post-treatment in 67% of sessions. A trend towards a reduction in medication use was observed (<em>p</em> <!-->=<!--> <!-->0.075). No changes in headache severity (<em>p</em> <!-->=<!--> <!-->0.16) or duration (<em>p</em> <!-->=<!--> <!-->0.34) were present.</p></div><div><h3>Conclusion</h3><p>These data suggest that combined tDCS and tsDCS intervention is safe and feasible, and may improve headache frequency in patients with chronic primary headache disorders.</p></div>","PeriodicalId":44774,"journal":{"name":"Hong Kong Physiotherapy Journal","volume":"37 ","pages":"Pages 1-9"},"PeriodicalIF":0.9000,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkpj.2016.11.001","citationCount":"11","resultStr":"{\"title\":\"Combined transcranial and trans-spinal direct current stimulation in chronic headache: A feasibility and safety trial for a novel intervention\",\"authors\":\"Ghufran Alhassani B.Med.Sc (Hons) , Julia Treleaven PhD , Siobhan S.M. Schabrun PhD\",\"doi\":\"10.1016/j.hkpj.2016.11.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Chronic primary headache disorders are associated with frequent, severe pain and significant functional impairment, with treatment remaining challenging.</p></div><div><h3>Objective</h3><p>We examined the feasibility and safety of a novel brain [transcranial direct current stimulation (tDCS)] and spinal cord stimulation [trans-spinal cord direct current stimulation (tsDCS)] treatment in chronic headache.</p></div><div><h3>Methods</h3><p>Nine participants (3 males; aged, 40<!--> <!-->±<!--> <!-->15 years) suffering from chronic daily headache, chronic tension-type headache, or chronic migraine received the combined brain and spinal cord intervention for 5 consecutive days. Stimulation was applied for a total of 40 minutes (20 minutes of tDCS followed by 20 minutes of tsDCS) at 1 mA. Pain sensitivity and headache symptoms (frequency, severity, duration, and medications recorded via a headache diary, 4 weeks before and after treatment) were assessed.</p></div><div><h3>Results</h3><p>The treatment was safe, feasible, and well tolerated. Headache frequency was reduced following the treatment (<em>p</em> <!-->=<!--> <!-->0.026) in chronic tension-type headache and chronic migraine, but not in chronic daily headache. Headache severity was reduced immediately post-treatment in 67% of sessions. A trend towards a reduction in medication use was observed (<em>p</em> <!-->=<!--> <!-->0.075). No changes in headache severity (<em>p</em> <!-->=<!--> <!-->0.16) or duration (<em>p</em> <!-->=<!--> <!-->0.34) were present.</p></div><div><h3>Conclusion</h3><p>These data suggest that combined tDCS and tsDCS intervention is safe and feasible, and may improve headache frequency in patients with chronic primary headache disorders.</p></div>\",\"PeriodicalId\":44774,\"journal\":{\"name\":\"Hong Kong Physiotherapy Journal\",\"volume\":\"37 \",\"pages\":\"Pages 1-9\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2017-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.hkpj.2016.11.001\",\"citationCount\":\"11\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hong Kong Physiotherapy Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1013702516300926\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hong Kong Physiotherapy Journal","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1013702516300926","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"REHABILITATION","Score":null,"Total":0}
Combined transcranial and trans-spinal direct current stimulation in chronic headache: A feasibility and safety trial for a novel intervention
Background
Chronic primary headache disorders are associated with frequent, severe pain and significant functional impairment, with treatment remaining challenging.
Objective
We examined the feasibility and safety of a novel brain [transcranial direct current stimulation (tDCS)] and spinal cord stimulation [trans-spinal cord direct current stimulation (tsDCS)] treatment in chronic headache.
Methods
Nine participants (3 males; aged, 40 ± 15 years) suffering from chronic daily headache, chronic tension-type headache, or chronic migraine received the combined brain and spinal cord intervention for 5 consecutive days. Stimulation was applied for a total of 40 minutes (20 minutes of tDCS followed by 20 minutes of tsDCS) at 1 mA. Pain sensitivity and headache symptoms (frequency, severity, duration, and medications recorded via a headache diary, 4 weeks before and after treatment) were assessed.
Results
The treatment was safe, feasible, and well tolerated. Headache frequency was reduced following the treatment (p = 0.026) in chronic tension-type headache and chronic migraine, but not in chronic daily headache. Headache severity was reduced immediately post-treatment in 67% of sessions. A trend towards a reduction in medication use was observed (p = 0.075). No changes in headache severity (p = 0.16) or duration (p = 0.34) were present.
Conclusion
These data suggest that combined tDCS and tsDCS intervention is safe and feasible, and may improve headache frequency in patients with chronic primary headache disorders.
期刊介绍：
The Hong Kong Physiotherapy Journal is the official journal of the Hong Kong Physiotherapy Association Limited (HKPA Ltd). This peer-reviewed journal aims to contribute to and document the advancements in the principles and practice of physiotherapy in Hong Kong.The Hong Kong Physiotherapy Journal is published annually and papers are categorized into research reports, treatment reports, technical reports, literature reviews, and letters to the editor.
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