阿片能
磁刺激
(+)-纳洛酮
医学
麻醉
刺激
随机对照试验
生理盐水
内源性阿片
背外侧前额叶皮质
类阿片
心理学
神经科学
前额叶皮质
内科学
受体
认知
作者
Ying Li,Junfeng Sun,Chao Wu,Jinxuan Ren,Yanni He,Na Sun,Bangqin Huang,Qunshan Chen,Dan Liú,Yangyuxin Huang,Feng Xu,Yu Lu,Bernadette M. Fitzgibbon,Robin Cash,Paul B. Fitzgerald,Min Yan,Min Yan
出处
期刊:Pain
[Ovid Technologies (Wolters Kluwer)]
日期:2024-03-26
标识
DOI:10.1097/j.pain.0000000000003220
摘要
Repetitive transcranial magnetic stimulation (rTMS) is a promising technology to reduce chronic pain. Investigating the mechanisms of rTMS analgesia holds the potential to improve treatment efficacy. Using a double-blind and placebo-controlled design at both stimulation and pharmacologic ends, this study investigated the opioidergic mechanisms of rTMS analgesia by abolishing and recovering analgesia in 2 separate stages across brain regions and TMS doses. A group of 45 healthy participants were equally randomized to the primary motor cortex (M1), the dorsolateral prefrontal cortex (DLPFC), and the Sham group. In each session, participants received an intravenous infusion of naloxone or saline before the first rTMS session. Participants then received a second dose of rTMS session after the drugs were metabolized at 90 minutes. M1-rTMS-induced analgesia was abolished by naloxone compared with saline and was recovered by the second rTMS run when naloxone was metabolized. In the DLPFC, double but not the first TMS session induced significant pain reduction in the saline condition, resulting in less pain compared with the naloxone condition. In addition, TMS over the M1 or DLPFC selectively increased plasma concentrations of β-endorphin or encephalin, respectively. Overall, we present causal evidence that opioidergic mechanisms are involved in both M1-induced and DLPFC-rTMS-induced analgesia; however, these are shaped by rTMS dosage and the release of different endogenous opioids.
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