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首页> 外文期刊>Pain research & management: the journal of the Canadian Pain Society = journal de la socie?te? canadienne pour le traitement de la douleur >The Contribution of Endogenous Modulatory Systems to TMS- and tDCS-Induced Analgesia: Evidence from PET Studies
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The Contribution of Endogenous Modulatory Systems to TMS- and tDCS-Induced Analgesia: Evidence from PET Studies

机译：内源性调节系统对TMS和TDCS诱导的镇痛的贡献：来自宠物研究的证据

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摘要

Chronic pain is an important public health issue. Moreover, its adequate management is still considered a major clinical problem, mainly due to its incredible complexity and still poorly understood pathophysiology. Recent scientific evidence coming from neuroimaging research, particularly functional magnetic resonance (fMRI) and positron emission tomography (PET) studies, indicates that chronic pain is associated with structural and functional changes in several brain structures that integrate antinociceptive pathways and endogenous modulatory systems. Furthermore, the last two decades have witnessed a huge increase in the number of studies evaluating the clinical effects of noninvasive neuromodulatory methods, especially transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), which have been proved to effectively modulate the cortical excitability, resulting in satisfactory analgesic effects with minimal adverse events. Nevertheless, the precise neuromechanisms whereby such methods provide pain control are still largely unexplored. Recent studies have brought valuable information regarding the recruitment of different modulatory systems and related neurotransmitters, including glutamate, dopamine, and endogenous opioids. However, the specific neurocircuits involved in the analgesia produced by those therapies have not been fully elucidated. This review focuses on the current literature correlating the clinical effects of noninvasive methods of brain stimulation to the changes in the activity of endogenous modulatory systems.
机译：慢性痛是一个重要的公共卫生问题。此外，其充分的管理仍然被认为是一个主要的临床问题，主要是由于其令人难以置信的复杂性，并且仍然仍然理解病理生理学。最近来自神经影像学研究的科学证据，特别是功能性磁共振（FMRI）和正电子发射断层扫描（PET）研究表明，慢性疼痛与若干脑结构中的结构和功能变化有关，其整合抗抗体途径和内源性调节系统。此外，过去二十年目睹了非侵入性神经调节方法的临床影响，特别是经颅磁刺激（TMS）和经颅直流刺激（TDC）的研究数量巨大增加，这已被证明有效地调节皮层兴奋性，导致令人满意的镇痛作用，具有最小的不良事件。然而，这种方法提供疼痛控制的精确神经机构仍然很大程度上是未开发的。最近的研究已经带来了有关募集不同调节系统和相关神经递质的有价值的信息，包括谷氨酸，多巴胺和内源性阿片类药物。然而，涉及这些疗法产生的镇痛的特异性神经细胞曲线尚未完全阐明。本综述重点介绍目前的文献与脑刺激非血管刺激的临床效果相关，对内源性调节系统活性的变化。

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