Analgesic efficacy of transcranial combined peripheral magnetic stimulation in chronic nonspecific low back pain: a fNIRS study.

IF 3.4 3区 医学 Q1 REHABILITATION
Chong Li, Jing Hu, Chengqi He
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Abstract

Background: Magnetic stimulation has a potential therapeutic effect on patients with chronic nonspecific low back pain (CNLBP). However, the efficacy and underlying brain mechanisms of closed-loop magnetic stimulation for CNLBP remain unclear.

Aim: This study aims to investigate the analgesic efficacy and brain activation of repetitive transcranial magnetic stimulation (rTMS) combined with repetitive peripheral magnetic stimulation (rPMS) in patients with CNLBP.

Design: This was a single-center, double-blind, randomized controlled trial.

Setting: Huashan Hospital.

Population: CNLBP.

Methods: Thirty patients with CNLBP were randomly allocated into the experimental group and control group, with fifteen patients in each group. Patients in both groups received CNLBP-related health education. On this basis, patients in the experimental group received a two-week rTMS combined with rPMS treatment, while the control group received rPMS treatment combined with sham-rTMS stimulation. Visual analogue scale (VAS), Oswestry Disability Index (ODI), and Neurometer CPT sensory nerve quantitative detector were used to evaluate the participants before and after treatment. In addition, functional near-infrared imaging (fNIRS) was employed to ascertain participants' brain function.

Results: After treatment, both groups exhibited a significant decrease in VAS and ODI scores compared to their pre-treatment levels (all P<0.05). While there was no statistical significance between the two groups. Neurometer CPT revealed that the experimental group improved the pain threshold of C-fiber on the unaffected side (P=0.036). In addition, compared with the control group, the experimental group exhibited a notable increase in the activation of the somatosensory association cortex (SAC) region and an improvement in the functional connectivity of brain regions, including SAC and the primary motor cortex (PMC), after treatment.

Conclusions: Combining rTMS with rPMS can significantly relieve pain and remodel brain regions in individuals with CNLBP. This closed-loop rehabilitation model paradigm merits additional clinical investigation and implementation.

Clinical rehabilitation impact: Magnetic stimulation therapy based on closed-loop rehabilitation mode has a good prospect for clinical rehabilitation for patients with CNLBP.

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经颅联合外周磁刺激治疗慢性非特异性腰痛的镇痛效果:fNIRS研究。
背景:磁刺激对慢性非特异性腰痛(CNLBP)患者具有潜在的治疗效果。然而,闭环磁刺激CNLBP的疗效和潜在的脑机制尚不清楚。目的:探讨重复性经颅磁刺激(rTMS)联合重复性外周磁刺激(rPMS)对CNLBP患者的镇痛效果及脑激活情况。设计:这是一项单中心、双盲、随机对照试验。单位:华山医院。人口:CNLBP。方法:将30例CNLBP患者随机分为实验组和对照组,每组15例。两组患者均接受cnlbp相关健康教育。在此基础上,实验组患者接受为期两周的rTMS联合rPMS治疗,对照组患者接受rPMS联合假rTMS刺激治疗。采用视觉模拟量表(Visual analogue scale, VAS)、Oswestry残疾指数(Oswestry Disability Index, ODI)和Neurometer CPT感觉神经定量检测器对治疗前后受试者进行评价。此外,使用功能性近红外成像(fNIRS)来确定参与者的脑功能。结果:治疗后,两组患者的VAS和ODI评分均较治疗前显著下降(p < 0.05)。结论:rTMS联合rPMS可显著缓解CNLBP患者的疼痛和脑区重塑。这种闭环康复模式值得进一步的临床研究和实施。临床康复影响:基于闭环康复模式的磁刺激疗法在CNLBP患者的临床康复中具有良好的前景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.50
自引率
4.40%
发文量
162
审稿时长
6-12 weeks
期刊介绍: The European Journal of Physical and Rehabilitation Medicine publishes papers of clinical interest in physical and rehabilitation medicine.
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