运动皮质刺激治疗神经病理性疼痛研究进展

Research progress of motor cortex stimulation for neuropathic pain

不同原因导致的外周和中枢神经病理性疼痛在临床具有较高的发病率,且治疗效果往往欠佳。运动皮质刺激(motor cortex stimulation,MCS)是20世纪80年代出现的一种治疗慢性疼痛的方法,因其对疼痛良好的治疗效果而被越来越多的用于临床。近年来,更多的运动皮质刺激技术方法得以发展,镇痛效果也不断提高。本文主要梳理了在疼痛治疗中,硬膜外运动皮质刺激(epidural motor cortex stimulation,eMCS)、重复经颅磁刺激(transcranial magnetic repetitive stimulation,rTMS)、经颅直流电刺激(transcranial direct current stimulation,tDCS)的临床疗效和镇痛机制,以期推动运动皮质刺激镇痛的基础研究和临床应用。

Peripheral and central neuropathic pain can be induced by various conditions and have relatively high morbidity,but the existing treatments are not sufficiently effective.Motor cortex stimulation(MCS)has been emerged as an alternative treatment for chronic pain from 1980s and exhibited substantial analgesic effect in wide clinical application.In recent years,more technologies of MCS have been developed and the analgesia of MCS has been constantly improved.In this review,we focus on the clinical efficacy and analgesic mechanisms of epidural motor cortex stimulation(eMCS),transcranial magnetic repetitive stimulation(rTMS),and transcranial direct current stimulation(tDCS)in pain treatment,in order to promote the basic research and clinical application of MCS.