双靶点经颅直流电刺激的镇痛效果及其神经机制研究
文献类型：学位论文
| 作者 | 邱 义 |
| 答辩日期 | 2024-06 |
| 文献子类 | 硕士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 涂毅恒 |
| 关键词 | 经颅直流电刺激 双靶点 tDCS 镇痛 背外侧前额叶 初级运动皮层 |
| 学位名称 | 应用心理硕士 |
| 学位专业 | 应用心理 |
| 其他题名 | The behavioral effect and neural mechanism of dual-target transcranial direct current stimulation for pain relief |
| 中文摘要 | Currently, transcranial direct current stimulation (tDCS) interventions encounter challenges characterized by inadequate analgesic efficacy, substantial individual variability and an unidentified mechanism in pain relief. These challenges might arise from the intricate nature of pain neural networks and the current limitation of tDCS modulation targeting a single brain region. The processing of nociceptive information occurs through parallel pathways, facilitating concurrent information flow among various brain regions. Existing tDCS pain studies predominantly target either the primary motor cortex (M1) to modulate pain sensation or the dorsolateral prefrontal cortex (DLPFC) to modulate pain cognition. However，such single-target stimulation approaches fail to comprehensively affect the parallel nociceptive processing pathways. In this study, a high-definition dual-target tDCS technique was applied to synchronously stimulate the DLPFC and M1. Through modulation of the distinct pain transmission pathways associated with the DLPFC and M1, the analgesic effects and potential advantages of dual-target tDCS were elucidated, while also exploring preliminary insights into its neural mechanisms of pain relief. In Study 1, a total of 80 healthy participants were double-blindly randomized to receive either lDLPFC+rM1-tDCS, lDLPFC-tDCS, rM1-tDCS, or sham-tDCS. Prior to and following tDCS modulation, transient pain perception induced by fixed-intensity thermal stimulation (corresponding to subjective pain intensity ratings of 5 or 8 points) and pressure pain thresholds were assessed. The analgesic effect of dual-target tDCS on transient pain was tested by comparing the changes in pain ratings and pressure pain thresholds before and after tDCS modulation in each group. The results showed that dual-target tDCS demonstrated a significant analgesic effect on moderate-intensity transient pain and pressure pain thresholds, surpassing the effects observed in the lDLPFC-tDCS or rM1-tDCS groups. Furthermore, we studied the individual differences of dual-target tDCS’s effect on alleviating pain and found a significant correlation with participants’ fear of pain. Specifically, the more intense the fear is, the better effects the modulation can be obtained. In Study 2, a total of 26 participants double-blindly recieved three different intervention conditions: lDLPFC+rM1-tDCS (dual-target), lDLPFC or rM1-tDCS (single-target), and sham. The sequence of these conditions was randomized with a minimum of seven days between sessions. During the experiment, capsaicin was applied to the skin beneath the wrist crease of the participants’ left arms to induce sustained pain. Following the onset of capsaicin's effects, tDCS modulation was applied for 20 minutes. Perception of capsaicin-induced sustained pain was assessed during tDCS modulation and 30 minutes post-stimulation. The results showed that during and after the tDCS modulation, the pain intensity ratings were significantly lower in the dual-target tDCS group compared to both the sham stimulation group and the singletarget tDCS group. applied to the skin beneath the wrist crease of the participants’ left arms to induce sustained pain. Following the onset of capsaicin's effects, tDCS modulation was applied for 20 minutes. Perception of capsaicin-induced sustained pain was assessed during tDCS modulation and 30 minutes post-stimulation. The results showed that during and after the tDCS modulation, the pain intensity ratings were significantly lower in the dual-target tDCS group compared to both the sham stimulation group and the singletarget tDCS group. In conclusion, this study highlighted the advantageous effects of dual-target tDCS in alleviating both transient pain, sustained pain, and pressure pain thresholds, offering crucial empirical validation for the theory of parallel processing in pain neural networks. Additionally, it provided scientific evidence for the potential application of dual-target tDCS in pain management. Despite the absence of discernible modulation of neural oscillations during the sustained pain process with dual-target tDCS in this study, it suggested that the analgesic effects may be mediated by alternative underlying mechanisms. |
| 英文摘要 | 目前，经颅直流电刺激(transcranial direct current stimulation，tDCS)镇痛的 研究中存在效果不佳、个体差异较大且镇痛机制不明的问题。这可能与疼痛神 经网络的复杂性及当前 tDCS 调控靶点单一有关。伤害性信息的加工表现为信息 流经一个脑区以平行路径传递至其他脑区的并行处理方式，而当前的 tDCS 镇痛研究主要以初级运动皮层(primary motor cortex，M1)为靶点调节疼痛感觉，或以背外侧前额叶(dorsolateral prefrontal cortex，DLPFC)为靶点调节疼痛认知，这种单一靶点的刺激方式无法对并行的伤害性处理过程产生全局性的影响，因此疗效不佳。为提高 tDCS 缓解疼痛的效果，本研究通过开展双盲随机对照实验，采用高精度双靶点 tDCS 技术，通过对 DLPFC 和 M1 进行同步刺激，以调节 DLPFC和 M1 所属不同的疼痛传导通路，揭示双靶点 tDCS 的镇痛效果及其潜在优势，并初步探索其镇痛的神经机制。 研究一共采集了 80 名健康被试数据，将被试随机分配到四个不同 tDCS 组别中：lDLPFC+rM1-tDCS 组(21 名)、lDLPFC-tDCS 组(20 名)、rM1-tDCS 组(20 名)和假刺激组(19名)。在tDCS调控前和调控后，给被试施加固定强度的短时热 痛刺激(主观疼痛评分对应 5 分或 8 分)，并进行压痛阈限测试。通过对比各组 tDCS 调控前、后疼痛评分及压痛阈限的变化值，检验双靶点 tDCS 对短时疼痛 的镇痛效果。结果显示，与假刺激组和 lDLPFC-tDCS 组相比，lDLPFC+rM1- tDCS 组可以显著降低中等疼痛强度时被试的主观疼痛强度评分。与假刺激组和 rM1-tDCS 组相比，lDLPFC+rM1-tDCS 组显著提高了压痛阈限。此外，研究还 探索了双靶点 tDCS 镇痛效果存在个体差异的原因，发现其与被试的疼痛恐惧特 质有关，表现为被试越恐惧，调控效果越好。 研 究 二 共 纳 入 了 26 名 健 康 被 试 数 据 ， 被 试 均 要 接 受 双 靶 点 tDCS(lDLPFC+rM1-tDCS)、单靶点 tDCS(lDLPFC-tDCS 或 rM1-tDCS，各 13 名) 及假刺激三种条件的处理，条件间间隔至少 7 天，顺序随机。实验中，在被试左手臂内侧的皮肤上涂抹辣椒素，待辣椒素生效诱发疼痛后，施加 20 分钟的 tDCS 调控。通过比较各 tDCS 条件调控过程中和调控后的疼痛评分，检验双靶点 tDCS 对持续性疼痛的镇痛效果。结果显示，调控过程中及调控后，双靶点 tDCS 处理的主观疼痛强度评分显著低于假刺激及单靶点 tDCS 条件。 研究三共纳入了 24 名健康被试数据，通过对研究二中同步采集的脑电数据 进行频谱分析，探究 tDCS 调控持续性疼痛的神经生理机制。结果显示，与基线 状 态 相 比 ， 疼 痛 诱 发 状 态 下 theta(4-8Hz)、alpha(8-12Hz)、beta(12-30Hz)、 gamma(30-45Hz)频段的能量显著升高，这一结果与前人持续性疼痛脑电研究的结果一致。在 tDCS 调控后 5 分钟，通过对双靶点 tDCS 及假刺激处理中被试的主观疼痛强度评分与上述各频段的能量进行相关分析，结果表明，beta 及 gamma 振荡功率与主观疼痛强度评分呈显著正相关。然而，直接对比双靶点组与假刺激组各频段能量未发现显著性差异，这与该时间段行为结果(即双靶点条件的主观疼痛强度评分显著低于假刺激条件)不对应。 综上，本研究揭示了双靶点 tDCS 缓解短时热痛和持续性疼痛的优势效果，为支持疼痛神经网络的并行处理理论提供了重要的实证支持，同时为双靶点 tDCS 在疼痛治疗中的潜在应用提供了科学依据。尽管本研究未发现双靶点 tDCS 对持续性疼痛过程中的神经振荡能量产生有效调节，但其结果提示，双靶点 tDCS 的镇痛效应可能是通过其他潜在的机制实现。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/48146]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 邱 义. 双靶点经颅直流电刺激的镇痛效果及其神经机制研究[D]. 中国科学院心理研究所. 中国科学院大学. 2024. |
入库方式： OAI收割
来源：心理研究所
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