1
|
Li J, Li Y, Huang M, Li D, Wan T, Sun F, Zeng Q, Xu F, Wang J. The most fundamental and popular literature on functional near-infrared spectroscopy: a bibliometric analysis of the top 100 most cited articles. Front Neurol 2024; 15:1388306. [PMID: 38756218 PMCID: PMC11096499 DOI: 10.3389/fneur.2024.1388306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
Background Functional near infrared spectroscopy (fNIRS) has developed rapidly in recent years, and there are more and more studies on fNIRS. At present, there is no bibliometric analysis of the top 100 most cited articles on fNIRS research. Objective To identify the top 100 most cited articles on fNIRS and analyze those most fundamental and popular articles through bibliometric research methods. Methods The literature on fNIRS of web of science from 1990 to 2023 was searched and the top 100 most cited articles were identified by citations. Use the bibliometrix package in R studio and VOSviewer for data analysis and plotting to obtain the output characteristics and citation status of these 100 most cited articles, and analyze research trends in this field through keywords. Results A total of 9,424 articles were retrieved from web of science since 1990. The average citation number of the 100 articles was 457.4 (range from 260 to 1,366). Neuroimage published the most articles (n = 31). Villringer, A. from Leipzig University had the largest number of top 100 papers. Harvard University (n = 22) conducted most cited articles. The United States, Germany, Japan, and the United Kingdom had most cited articles, respectively. The most common keywords were near-infrared spectroscopy, activation, cerebral-blood-flow, brain, newborn-infants, oxygenation, cortex, fMRI, spectroscopy. The fund sources mostly came from National Institutes of Health Unitd States (NIH) and United States Department of Health Human Services (n = 28). Conclusion Neuroimage was the most popular journal. The top countries, institutions, and authors were the United States, Harvard University, and Villringer, A., respectively. Researchers and institutions from North America and Europe contributed the most. Near-infrared spectroscopy, activation, cerebral-blood-flow, brain, newborn-infants, oxygenation, cortex, fmri, spectroscopy, stimulation, blood-flow, light-propagation, infants, tissue comprise the future research directions and potential topic hotspots for fNIRS.
Collapse
Affiliation(s)
- Jiyang Li
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yang Li
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Maomao Huang
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Dan Li
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Tenggang Wan
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Fuhua Sun
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Qiu Zeng
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Fangyuan Xu
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jianxiong Wang
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Rehabilitation Medicine and Engineering Key Laboratory of Luzhou, Luzhou, Sichuan, China
| |
Collapse
|
2
|
Chen DY, Di X, Amaya N, Sun H, Pal S, Biswal BB. Brain activation during the N-back working memory task in individuals with spinal cord injury: a functional near-infrared spectroscopy study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.09.579655. [PMID: 38405769 PMCID: PMC10888902 DOI: 10.1101/2024.02.09.579655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Cognitive impairments have frequently been reported in individuals with spinal cord injury (SCI) across different domains such as working memory, attention, and executive function. The mechanism of cognitive impairment after SCI is not well understood due to the heterogeneity of SCI sample populations, and may possibly be due to factors such as cardiovascular dysfunction, concomitant traumatic brain injury (TBI), hypoxia, sleep disorders, and body temperature dysregulation. In this study, we implement the Neuropsychiatric Unit Cognitive Assessment Tool (NUCOG) to assess cognitive differences between individuals with SCI and age-matched able-bodied (AB) controls. We then use an N-back working memory task and functional near-infrared spectroscopy (fNIRS) to elucidate the neurovascular correlates of cognitive function in individuals with SCI. We observed significant differences between the SCI and AB groups on measures of executive function on the NUCOG test. On the N-back task, across the three levels of difficulty: 0-back, 2-back, and 3-back, no significant differences were observed between the SCI and AB group; however, both groups performed worse as the level of difficulty increased. Although there were no significant differences in N-back performance scores between the two groups, functional brain hemodynamic activity differences were observed between the SCI and AB groups, with the SCI group exhibiting higher maximum oxygenated hemoglobin concentration in the right inferior parietal lobe. These findings support the use of fNIRS to study cognitive function in individuals with SCI and may provide a useful tool during rehabilitation to obtain quantitative functional brain activity metrics.
Collapse
Affiliation(s)
- Donna Y. Chen
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, US
- Rutgers Biomedical and Health Sciences, Rutgers School of Graduate Studies, Newark, NJ, US
| | - Xin Di
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, US
| | - Nayyar Amaya
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, US
| | - Hai Sun
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, US
| | - Saikat Pal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, US
- Electrical and Computer Engineering Department, New Jersey Institute of Technology, Newark, NJ, US
- Spinal Cord Damage Research Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, US
| | - Bharat B. Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, US
| |
Collapse
|
3
|
Wang Y, Dong T, Li X, Zhao H, Yang L, Xu R, Fu Y, Li L, Gai X, Qin D. Research progress on the application of transcranial magnetic stimulation in spinal cord injury rehabilitation: a narrative review. Front Neurol 2023; 14:1219590. [PMID: 37533475 PMCID: PMC10392830 DOI: 10.3389/fneur.2023.1219590] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Traumatic or non-traumatic spinal cord injury (SCI) can lead to severe disability and complications. The incidence of SCI is high, and the rehabilitation cycle is long, which increases the economic burden on patients and the health care system. However, there is no practical method of SCI treatment. Recently, transcranial magnetic stimulation (TMS), a non-invasive brain stimulation technique, has been shown to induce changes in plasticity in specific areas of the brain by regulating the activity of neurons in the stimulation site and its functionally connected networks. TMS is a new potential method for the rehabilitation of SCI and its complications. In addition, TMS can detect the activity of neural circuits in the central nervous system and supplement the physiological evaluation of SCI severity. This review describes the pathophysiology of SCI as well as the basic principles and classification of TMS. We mainly focused on the latest research progress of TMS in the physiological evaluation of SCI as well as the treatment of motor dysfunction, neuropathic pain, spasticity, neurogenic bladder, respiratory dysfunction, and other complications. This review provides new ideas and future directions for SCI assessment and treatment.
Collapse
Affiliation(s)
- Yuhong Wang
- Department of Rehabilitation Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Tingting Dong
- Department of Rehabilitation Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Xiahuang Li
- Department of Neurosurgery, Mengzi People’s Hospital, Mengzi, China
| | - Huiyun Zhao
- Department of Rehabilitation Medicine, Dongchuan District People’s Hospital, Kunming, China
| | - Lili Yang
- Department of Rehabilitation Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Rui Xu
- Department of Rehabilitation Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yi Fu
- Department of Pulmonary and Critical Care Medicine, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Li Li
- Department of Emergency Trauma Surgery, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Xuesong Gai
- Department of Rehabilitation Medicine, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Dongdong Qin
- Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Neuropsychiatric Diseases, Yunnan University of Chinese Medicine, Kunming, China
| |
Collapse
|
4
|
Koukoulithras I, Alkhazi A, Gkampenis A, Stamouli A, Plexousakis M, Drousia G, Xanthi E, Roussos C, Kolokotsios S. A Systematic Review of the Interventions for Management of Pain in Patients After Spinal Cord Injury. Cureus 2023; 15:e42657. [PMID: 37644939 PMCID: PMC10461890 DOI: 10.7759/cureus.42657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2023] [Indexed: 08/31/2023] Open
Abstract
Chronic pain is a very common problem in patients with spinal cord injury (SCI) as it affects 80% of these patients, which negatively affects their quality of life. Despite many advantages that exist in the management of any type of pain (neuropathic, nociceptive, mixed) in these patients, there is no cure, and the analgesic effect of some treatments is inadequate. This study aims to conduct an evidence-based systematic review regarding the various interventions used for the management of pain after SCI. The PubMed, Physiotherapy Evidence Database (PEDro), and Cochrane Library databases were searched from 1969 to 2023. The risk of bias was assessed using the PEDro scoring system. A total of 57 studies met the inclusion criteria and were included in this systematic review. Among the different interventions at present, 18 studies examined the role of oral medications, 11 studies examined the role of minimally invasive methods (injection and infusion), 16 studies investigated physiotherapy and alternative treatments, and 12 studies examined the role of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and cranial electrotherapy stimulation (CES) in the management of pain in patients after SCI. Gabapentin and pregabalin are very effective in managing chronic neuropathic pain after SCI, and pregabalin also seems to reduce anxiety and sleep disturbances in the patients. It is noteworthy that lamotrigine, valproate, and carbamazepine do not have an analgesic effect, but mirogabalin is a novel and promising drug. Antidepressants (selective serotonin reuptake inhibitors and serotonin and noradrenaline reuptake inhibitors) did not reduce the pain of the patients, although some studies showed an efficacy of amitriptyline especially in depressed patients and tramadol should be considered short-term with caution. Also, tDCS and rTMS reduced pain. Moreover, botulinum toxin type A, lidocaine, ketamine, and intrathecal baclofen significantly reduced pain intensity, although the sample of the studies was small. Physiotherapy and alternative treatments seem to relieve pain, and transcutaneous electrical nerve stimulation had the greatest reduction of pain intensity. In conclusion, several pharmaceutical and non-pharmaceutical methods exist, which can reduce pain in patients after SCI. The type of intervention can be considered by the physician depending on the patients' preference, age, medical history, type of pain, and associated symptoms. However, more studies with greater samples and with better methodological quality should be conducted.
Collapse
Affiliation(s)
- Ioannis Koukoulithras
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, GRC
- Faculty of Medicine, University of Ioannina, Ioannina, GRC
| | - Abdulaziz Alkhazi
- Department of Neurosurgery, Mater Dei Hospital, Msida, MLT
- Faculty of Medicine, University of Malta, Imsida, MLT
| | - Athanasios Gkampenis
- Department of Neurosurgery, University Hospital of Ioannina, Ioannina, GRC
- Faculty of Medicine, University of Ioannina, Ioannina, GRC
| | - Alexandra Stamouli
- Department of Physical Therapy, University Hospital, University of West Attica, Athens, GRC
- Faculty of Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | - Minas Plexousakis
- Department of Physical Therapy, University Hospital, University of West Attica, Athens, GRC
| | - Gianna Drousia
- Department of Physical Therapy, University Hospital, University of West Attica, Athens, GRC
| | - Eleana Xanthi
- Department of Physical Therapy, University Hospital, University of West Attica, Athens, GRC
| | - Charis Roussos
- Department of Physical Medicine and Rehabilitation, Mitera Hospital, Athens, GRC
| | - Spyridon Kolokotsios
- Department of Physical Therapy, University Hospital, University of West Attica, Athens, GRC
| |
Collapse
|
5
|
Bai YW, Yang QH, Chen PJ, Wang XQ. Repetitive transcranial magnetic stimulation regulates neuroinflammation in neuropathic pain. Front Immunol 2023; 14:1172293. [PMID: 37180127 PMCID: PMC10167032 DOI: 10.3389/fimmu.2023.1172293] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
Neuropathic pain (NP) is a frequent condition caused by a lesion in, or disease of, the central or peripheral somatosensory nervous system and is associated with excessive inflammation in the central and peripheral nervous systems. Repetitive transcranial magnetic stimulation (rTMS) is a supplementary treatment for NP. In clinical research, rTMS of 5-10 Hz is widely placed in the primary motor cortex (M1) area, mostly at 80%-90% RMT, and 5-10 treatment sessions could produce an optimal analgesic effect. The degree of pain relief increases greatly when stimulation duration is greater than 10 days. Analgesia induced by rTMS appears to be related to reestablishing the neuroinflammation system. This article discussed the influences of rTMS on the nervous system inflammatory responses, including the brain, spinal cord, dorsal root ganglia (DRG), and peripheral nerve involved in the maintenance and exacerbation of NP. rTMS has shown an anti-inflammation effect by decreasing pro-inflammatory cytokines, including IL-1β, IL-6, and TNF-α, and increasing anti-inflammatory cytokines, including IL-10 and BDNF, in cortical and subcortical tissues. In addition, rTMS reduces the expression of glutamate receptors (mGluR5 and NMDAR2B) and microglia and astrocyte markers (Iba1 and GFAP). Furthermore, rTMS decreases nNOS expression in ipsilateral DRGs and peripheral nerve metabolism and regulates neuroinflammation.
Collapse
Affiliation(s)
- Yi-Wen Bai
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qi-Hao Yang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Pei-Jie Chen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| |
Collapse
|
6
|
Zhao D, Zhang Y, Zheng Y, Li XT, Sun CC, Yang Q, Xie Q, Xu DS. Double-target neural circuit-magnetic stimulation improves motor function in spinal cord injury by attenuating astrocyte activation. Neural Regen Res 2022; 18:1062-1066. [PMID: 36254994 PMCID: PMC9827772 DOI: 10.4103/1673-5374.355768] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Multi-target neural circuit-magnetic stimulation has been clinically shown to improve rehabilitation of lower limb motor function after spinal cord injury. However, the precise underlying mechanism remains unclear. In this study, we performed double-target neural circuit-magnetic stimulation on the left motor cortex and bilateral L5 nerve root for 3 successive weeks in a rat model of incomplete spinal cord injury caused by compression at T10. Results showed that in the injured spinal cord, the expression of the astrocyte marker glial fibrillary acidic protein and inflammatory factors interleukin 1β, interleukin-6, and tumor necrosis factor-α had decreased, whereas that of neuronal survival marker microtubule-associated protein 2 and synaptic plasticity markers postsynaptic densification protein 95 and synaptophysin protein had increased. Additionally, neural signaling of the descending corticospinal tract was markedly improved and rat locomotor function recovered significantly. These findings suggest that double-target neural circuit-magnetic stimulation improves rat motor function by attenuating astrocyte activation, thus providing a theoretical basis for application of double-target neural circuit-magnetic stimulation in the clinical treatment of spinal cord injury.
Collapse
Affiliation(s)
- Dan Zhao
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Department of Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ye Zhang
- Department of Rehabilitation, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Ya Zheng
- Department of Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xu-Tong Li
- Department of Neurology, Zibo Centre Hospital, Zibo, Shandong Province, China
| | - Cheng-Cheng Sun
- Department of Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qi Yang
- Department of Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qing Xie
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Correspondence to: Qing Xie, ; Dong-Sheng Xu, .
| | - Dong-Sheng Xu
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China,School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Shanghai, China,Correspondence to: Qing Xie, ; Dong-Sheng Xu, .
| |
Collapse
|
7
|
Abstract
Pain is an unpleasant sensory and emotional experience. Understanding the neural mechanisms of acute and chronic pain and the brain changes affecting pain factors is important for finding pain treatment methods. The emergence and progress of non-invasive neuroimaging technology can help us better understand pain at the neural level. Recent developments in identifying brain-based biomarkers of pain through advances in advanced imaging can provide some foundations for predicting and detecting pain. For example, a neurologic pain signature (involving brain regions that receive nociceptive afferents) and a stimulus intensity-independent pain signature (involving brain regions that do not show increased activity in proportion to noxious stimulus intensity) were developed based on multivariate modeling to identify processes related to the pain experience. However, an accurate and comprehensive review of common neuroimaging techniques for evaluating pain is lacking. This paper reviews the mechanism, clinical application, reliability, strengths, and limitations of common neuroimaging techniques for assessing pain to promote our further understanding of pain.
Collapse
Affiliation(s)
- Jing Luo
- Department of Sport Rehabilitation, Xian Physical Education University, Xian, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Hui-Qi Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
| | - Bo Gou
- Department of Sport Rehabilitation, Xian Physical Education University, Xian, China.
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
| |
Collapse
|
8
|
Foglia SD, Rehsi RS, Turco CV, Shanthanna H, Nelson AJ. Case report: The feasibility of rTMS with intrathecal baclofen pump for the treatment of unresolved neuropathic pain following spinal cord injury. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:893014. [PMID: 36188893 PMCID: PMC9397973 DOI: 10.3389/fresc.2022.893014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/01/2022] [Indexed: 11/21/2022]
Abstract
The main objective of this study was to assess the efficacy and safety of 10 Hz repetitive transcranial magnetic stimulation (rTMS) for the treatment of unresolved neuropathic pain in an individual with spinal cord injury and an intrathecal baclofen pump. A 62-year-old male presented with drug resistant neuropathic pain as a result of a complete spinal cord lesion at T8 level. Pain was classified into four types: pressure pain in the left foot, burning pain in buttocks, burning pain in sternum, and electrical attacks in the trunk. The treatment period involved 6 weeks of rTMS stimulation performed 5 days per week, a 6-week follow up period with no stimulation, and an 8-week top up session period which began 5-weeks after the end of the follow up period. 2004 pulses were delivered at 10Hz over the right-hand representation of the left primary motor cortex at 80% resting motor threshold during each session. Assessments were based on the numerical rating scale (NRS), neuropathic pain scale (NPS), Hamilton Depression and Anxiety rating scales. Following the treatment period there was a 30, 13, and 29% reduction in sternum, buttocks, and left foot pain respectively, as reported by the NRS. During this time, electrical attacks were abolished following the third week of treatment. These changes corresponded to a 38% decrease in NPS scores and a 65 and 25% reduction in anxiety and depressions scores respectively. The changes in sternum, buttocks, and left foot pain reported on the NRS persisted for 1 week following treatment. Top up sessions delivered 11 weeks after the end of the treatment period were unsuccessful in reducing pain to the level achieved during the treatment period. A 13% reduction in NPS was seen during these 8-weeks. Anxiety and depression scores decreased 78 and 67% respectively. The frequency of electrical attacks was zero during this time. rTMS stimulation delivered throughout this study did not cause any interference with the functioning of the intrathecal baclofen pump. This case study illustrates that rTMS may be effective at reducing drug resistant neuropathic pain with certain pain types exhibiting greater propensity for change.
Collapse
Affiliation(s)
- Stevie D. Foglia
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Ravjot S. Rehsi
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Claudia V. Turco
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Harsha Shanthanna
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Aimee J. Nelson
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
- *Correspondence: Aimee J. Nelson
| |
Collapse
|
9
|
Pirvulescu I, Biskis A, Candido KD, Knezevic NN. Overcoming clinical challenges of refractory neuropathic pain. Expert Rev Neurother 2022; 22:595-622. [PMID: 35866187 DOI: 10.1080/14737175.2022.2105206] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : Refractory neuropathic pain (ReNP), and its definition, is widely disputed amongst clinicians due in part to unclear categorical diagnosing guidelines, overall time duration of neuropathic pain, and the exhaustiveness of treatment options. Usually ReNP is defined as chronic, intractable, and unresponsive neuropathic pain that have otherwise been untreatable. AREAS COVERED : In this narrative review, we discuss and summarize the effectiveness of prospective ReNP research conducted over the past 10 years. This research looks at pharmacological and interventional therapies in clinical trial settings. The pharmacological therapies discussed include the use of adjuvant treatments to improve the safety and efficacy of conventional approaches. Different modalities of administration, such as injection therapy and intrathecal drug delivery systems, provide targeted drug delivery. Interventional therapies such as neuromodulation, pulse radiofrequency, and nerve lesioning are more invasive, however, they are increasingly utilized in the field, as reflected in ongoing clinical trials. EXPERT OPINION : Based on the current data from RCTs and systematic reviews, it is clear that single drug therapy cannot be effective and has significant limitations. Transitioning to interventional modalities that showed more promising results sooner rather than later may be even more cost-efficient than attempting different conservative treatments with a high failure rate.
Collapse
Affiliation(s)
- Iulia Pirvulescu
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Alexandras Biskis
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.,Advocate Aurora Research Institute, Chicago, IL, USA.,College of Aviation, Science and Technology, Lewis University, Romeoville, IL, USA
| | - Kenneth D Candido
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.,Department of Anesthesiology, University of Illinois, Chicago, IL, USA.,Department of Surgery, University of Illinois, Chicago, IL, USA
| | - Nebojsa Nick Knezevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.,Department of Anesthesiology, University of Illinois, Chicago, IL, USA.,Department of Surgery, University of Illinois, Chicago, IL, USA
| |
Collapse
|
10
|
High-Frequency Repetitive Transcranial Magnetic Stimulation Regulates Astrocyte Activation by Modulating the Endocannabinoid System in Parkinson’s Disease. Mol Neurobiol 2022; 59:5121-5134. [DOI: 10.1007/s12035-022-02879-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
|
11
|
Yang QH, Zhang YH, Du SH, Wang YC, Fang Y, Wang XQ. Non-invasive Brain Stimulation for Central Neuropathic Pain. Front Mol Neurosci 2022; 15:879909. [PMID: 35663263 PMCID: PMC9162797 DOI: 10.3389/fnmol.2022.879909] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/04/2022] [Indexed: 12/15/2022] Open
Abstract
The research and clinical application of the noninvasive brain stimulation (NIBS) technique in the treatment of neuropathic pain (NP) are increasing. In this review article, we outline the effectiveness and limitations of the NIBS approach in treating common central neuropathic pain (CNP). This article summarizes the research progress of NIBS in the treatment of different CNPs and describes the effects and mechanisms of these methods on different CNPs. Repetitive transcranial magnetic stimulation (rTMS) analgesic research has been relatively mature and applied to a variety of CNP treatments. But the optimal stimulation targets, stimulation intensity, and stimulation time of transcranial direct current stimulation (tDCS) for each type of CNP are still difficult to identify. The analgesic mechanism of rTMS is similar to that of tDCS, both of which change cortical excitability and synaptic plasticity, regulate the release of related neurotransmitters and affect the structural and functional connections of brain regions associated with pain processing and regulation. Some deficiencies are found in current NIBS relevant studies, such as small sample size, difficulty to avoid placebo effect, and insufficient research on analgesia mechanism. Future research should gradually carry out large-scale, multicenter studies to test the stability and reliability of the analgesic effects of NIBS.
Collapse
Affiliation(s)
- Qi-Hao Yang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yong-Hui Zhang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Shu-Hao Du
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yu-Chen Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yu Fang
- School of Mechanical and Automotive Engineering, Shanghai University of Engineering Science, Shanghai, China
- *Correspondence: Yu Fang,
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- Xue-Qiang Wang,
| |
Collapse
|
12
|
Saleh C, Ilia TS, Jaszczuk P, Hund-Georgiadis M, Walter A. Is transcranial magnetic stimulation as treatment for neuropathic pain in patients with spinal cord injury efficient? A systematic review. Neurol Sci 2022; 43:3007-3018. [PMID: 35239053 DOI: 10.1007/s10072-022-05978-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 02/12/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Neuropathic pain is a clinically relevant complication in individuals with spinal cord injury (SCI). Pharmacological pain treatment is often insufficient and leads to undesirable side effects. Thus, alternative therapeutic approaches such as repetitive transcranial magnetic stimulation (rTMS) are of critical importance. We aimed to evaluate the effectiveness of rTMS in neuropathic pain secondary to SCI. METHODS We conducted a systematic review using the PubMed/MEDLINE, EMBASE, and PsycInfo (via OVID) database up April 2021. Only randomized controlled trials were included. Results regarding the pain intensity scores were pooled using a random-effects model. RESULTS The search identified a total of 203 potential articles. Of these, eight randomized controlled trials (RCTs) met the eligibility criteria for qualitative synthesis providing the total data of 141 patients. All studies applied high-frequency rTMS. In seven studies, rTMS was applied over the motor cortex, and in one study over the left dorsolateral prefrontal cortex. Five studies reported a significant improvement in baseline pain scores after treatment, and three studies found a significant difference between sham vs. non-sham stimulation at any time. Six RCTs were included in the quantitative synthesis and showed a significant overall reduction of pain intensity in the rTMS groups compared with the sham groups (mean difference - 0.81, 95%CI - 1.45 to - 0.17). CONCLUSIONS Our findings indicate that high-frequency rTMS of the primary motor cortex and left dorsolateral prefrontal cortex might be promising stimulation targets for neuropathic pain in SCI.
Collapse
Affiliation(s)
- Christian Saleh
- Clinic for Neurorehabilitation and Paraplegiology, REHAB Basel, Im Burgfelderhof 40, CH-4055, Basel, Switzerland
| | - Tatiani Soultana Ilia
- Clinic for Neurorehabilitation and Paraplegiology, REHAB Basel, Im Burgfelderhof 40, CH-4055, Basel, Switzerland
| | - Phillip Jaszczuk
- Clinic for Neurorehabilitation and Paraplegiology, REHAB Basel, Im Burgfelderhof 40, CH-4055, Basel, Switzerland
| | - Margret Hund-Georgiadis
- Clinic for Neurorehabilitation and Paraplegiology, REHAB Basel, Im Burgfelderhof 40, CH-4055, Basel, Switzerland
| | - Anna Walter
- Clinic for Neurorehabilitation and Paraplegiology, REHAB Basel, Im Burgfelderhof 40, CH-4055, Basel, Switzerland.
| |
Collapse
|
13
|
Garcia-Larrea L, Quesada C. Cortical stimulation for chronic pain: from anecdote to evidence. Eur J Phys Rehabil Med 2022; 58:290-305. [PMID: 35343176 PMCID: PMC9980528 DOI: 10.23736/s1973-9087.22.07411-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Epidural stimulation of the motor cortex (eMCS) was devised in the 1990's, and has now largely supplanted thalamic stimulation for neuropathic pain relief. Its mechanisms of action involve activation of multiple cortico-subcortical areas initiated in the thalamus, with involvement of endogenous opioids and descending inhibition toward the spinal cord. Evidence for clinical efficacy is now supported by at least seven RCTs; benefits may persist up to 10 years, and can be reasonably predicted by preoperative use of non-invasive repetitive magnetic stimulation (rTMS). rTMS first developed as a means of predicting the efficacy of epidural procedures, then as an analgesic method on its own right. Reasonable evidence from at least six well-conducted RCTs favors a significant analgesic effect of high-frequency rTMS of the motor cortex in neuropathic pain (NP), and less consistently in widespread/fibromyalgic pain. Stimulation of the dorsolateral frontal cortex (DLPFC) has not proven efficacious for pain, so far. The posterior operculo-insular cortex is a new and attractive target but evidence remains inconsistent. Transcranial direct current stimulation (tDCS) is applied upon similar targets as rTMS and eMCS; it does not elicit action potentials but modulates the neuronal resting membrane state. tDCS presents practical advantages including low cost, few safety issues, and possibility of home-based protocols; however, the limited quality of most published reports entails a low level of evidence. Patients responsive to tDCS may differ from those improved by rTMS, and in both cases repeated sessions over a long time may be required to achieve clinically significant relief. Both invasive and non-invasive procedures exert their effects through multiple distributed brain networks influencing the sensory, affective and cognitive aspects of chronic pain. Their effects are mainly exerted upon abnormally sensitized pathways, rather than on acute physiological pain. Extending the duration of long-term benefits remains a challenge, for which different strategies are discussed in this review.
Collapse
Affiliation(s)
- Luis Garcia-Larrea
- Central Integration of Pain (NeuroPain) Lab, Lyon Center for Neuroscience (CRNL), INSERM U1028, University Claude Bernard Lyon 1, Villeurbanne, France - .,University Hospital Pain Center (CETD), Neurological Hospital, Hospices Civils de Lyon, Lyon, France -
| | - Charles Quesada
- Central Integration of Pain (NeuroPain) Lab, Lyon Center for Neuroscience (CRNL), INSERM U1028, University Claude Bernard Lyon 1, Villeurbanne, France.,Department of Physiotherapy, Sciences of Rehabilitation Institute (ISTR), University Claude Bernard Lyon 1, Villeurbanne, France
| |
Collapse
|
14
|
Li L, Huang H, Yu Y, Jia Y, Liu Z, Shi X, Wang F, Zhang T. Non-invasive Brain Stimulation for Neuropathic Pain After Spinal Cord Injury: A Systematic Review and Network Meta-Analysis. Front Neurosci 2022; 15:800560. [PMID: 35221889 PMCID: PMC8873374 DOI: 10.3389/fnins.2021.800560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/27/2021] [Indexed: 11/29/2022] Open
Abstract
Objective This study aims to systematically evaluate the effect of non-invasive brain stimulation (NIBS) on neuropathic pain (NP) after spinal cord injury and compare the effects of two different NIBS. Methods Randomized controlled trials (RCTs) about the effect of NIBS on NP after spinal cord injury (SCI) were retrieved from the databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and CBM from inception to September 2021. The quality of the trials was assessed, and the data were extracted according to the Cochrane handbook of systematic review. Statistical analysis was conducted with Stata (version 16) and R software (version 4.0.2). Results A total of 17 studies involving 507 patients were included. The meta-analysis showed that NIBS could reduce the pain score (SMD = −0.84, 95% CI −1.27 −0.40, P = 0.00) and the pain score during follow-up (SMD = −0.32, 95%CI −0.57 −0.07, P = 0.02), and the depression score of the NIBS group was not statistically significant than that of the control group (SMD = −0.43, 95%CI −0.89–0.02, P = 0.06). The network meta-analysis showed that the best probabilistic ranking of the effects of two different NIBS on the pain score was repetitive transcranial magnetic stimulation (rTMS) (P = 0.62) > transcranial direct current stimulation (tDCS) (P = 0.38). Conclusion NIBS can relieve NP after SCI. The effect of rTMS on NP is superior to that of tDCS. We suggest that the rTMS parameters are 80–120% resting motion threshold and 5–20 Hz, while the tDCS parameters are 2 mA and 20 min. However, it is necessary to carry out more large-scale, multicenter, double-blind, high-quality RCT to explore the efficacy and mechanism of NIBS for NP after SCI.
Collapse
Affiliation(s)
- Lingling Li
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hailiang Huang
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- *Correspondence: Hailiang Huang
| | - Ying Yu
- Innovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuqi Jia
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhiyao Liu
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xin Shi
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fangqi Wang
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tingting Zhang
- College of Chemical Engineering and Technology, Hebei University of Technology, Tianjin, China
| |
Collapse
|
15
|
Mori N, Hosomi K, Nishi A, Dong D, Yanagisawa T, Khoo HM, Tani N, Oshino S, Saitoh Y, Kishima H. Difference in Analgesic Effects of Repetitive Transcranial Magnetic Stimulation According to the Site of Pain. Front Hum Neurosci 2021; 15:786225. [PMID: 34899224 PMCID: PMC8662379 DOI: 10.3389/fnhum.2021.786225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 01/09/2023] Open
Abstract
High-frequency repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex for neuropathic pain has been shown to be effective, according to systematic reviews and therapeutic guidelines. However, our large, rigorous, investigator-initiated, registration-directed clinical trial failed to show a positive primary outcome, and its subgroup analysis suggested that the analgesic effect varied according to the site of pain. The aim of this study was to investigate the differences in analgesic effects of rTMS for neuropathic pain between different pain sites by reviewing our previous clinical trials. We included three clinical trials in this mini meta-analysis: a multicenter randomized controlled trial at seven hospitals (N = 64), an investigator-initiated registration-directed clinical trial at three hospitals (N = 142), and an exploratory clinical trial examining different stimulation parameters (N = 22). The primary efficacy endpoint (change in pain scale) was extracted for each patient group with pain in the face, upper limb, or lower limb, and a meta-analysis of the efficacy of active rTMS against sham stimulation was performed. Standardized mean difference (SMD) with 95% confidence interval (CI) was calculated for pain change using a random-effects model. The analgesic effect of rTMS for upper limb pain was favorable (SMD = -0.45, 95% CI: -0.77 to -0.13). In contrast, rTMS did not produce significant pain relief on lower limb pain (SMD = 0.04, 95% CI: -0.33 to 0.41) or face (SMD = -0.24, 95% CI: -1.59 to 1.12). In conclusion, these findings suggest that rTMS provides analgesic effects in patients with neuropathic pain in the upper limb, but not in the lower limb or face, under the conditions of previous clinical trials. Owing to the main limitation of small number of studies included, many aspects should be clarified by further research and high-quality studies in these patients.
Collapse
Affiliation(s)
- Nobuhiko Mori
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Koichi Hosomi
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan,*Correspondence: Koichi Hosomi,
| | - Asaya Nishi
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Dong Dong
- Department of Mechanical Science and Bioengineering, Osaka University Graduate School of Engineering Science, Toyonaka, Japan
| | - Takufumi Yanagisawa
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan,Osaka University Institute for Advanced Co-Creation Studies, Suita, Japan
| | - Hui Ming Khoo
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Naoki Tani
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Satoru Oshino
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Youichi Saitoh
- Department of Mechanical Science and Bioengineering, Osaka University Graduate School of Engineering Science, Toyonaka, Japan,Tokuyukai Rehabilitation Clinic, Toyonaka, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| |
Collapse
|
16
|
Shi P, Liu J, Du J, Yu H, Fang F. Pain modulation induced by electronic wrist-ankle acupuncture: A functional near-infrared spectroscopy study. Pain Pract 2021; 22:182-190. [PMID: 34519161 DOI: 10.1111/papr.13076] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND As a new technology, electronic wrist-ankle acupuncture (E-WAA) combines the advantages of wrist-ankle acupuncture and transcutaneous electrical nerve stimulation, but the analgesic effect and mechanism need to be clarified. The purpose of this study was to identify the pain modulation caused by E-WAA by evaluating the response of the prefrontal cortex (PFC) from the perspective of neurophysiology. METHODS Fifty male volunteers (age 25.00 ± 1.05 years) with trapezius myofascial pain syndrome were randomly allocated into intervention group (E-WAA treatment) or sham control group at a 1:1 ratio. An outcome evaluation system was used to induce tenderness on the Jianjing point and record the pain value. A multichannel functional near-infrared spectroscope was used to detect the PFC activation during tenderness before and after treatment to demonstrate the neuromodulation mechanism. A general linear model and t-test (p < 0.05) were used to analyze the difference in the oxyhemoglobin (HbO) concentration and pain value. RESULTS In the intervention group, the pain value of volunteers decreased significantly (p = 0.017) after E-WAA treatment, whereas there was no statistical difference (p = 0.082) in the sham group. Before treatment, the frontopolar (FP) and dorsolateral prefrontal cortex (DLPFC) were the activation areas of the PFC. The E-WAA treatment then suppressed the activation of the two areas. The HbO concentration of the FP and DLPFC changed from a sharp rise during tenderness to not changing with tenderness stimulation. CONCLUSION The results demonstrated that the E-WAA have a great analgesic effect. The FP and DLPFC were relative to the analgesia neuromodulation induced by the E-WAA.
Collapse
Affiliation(s)
- Ping Shi
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Junwen Liu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Jiahao Du
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Fanfu Fang
- Changhai Hospital, Naval Medical University, Shanghai, China
| |
Collapse
|
17
|
Abstract
Spinal cord injury (SCI) destroys the sensorimotor pathway and blocks the information flow between the peripheral nerve and the brain, resulting in autonomic function loss. Numerous studies have explored the effects of obstructed information flow on brain structure and function and proved the extensive plasticity of the brain after SCI. Great progress has also been achieved in therapeutic strategies for SCI to restore the "re-innervation" of the cerebral cortex to the limbs to some extent. Although no thorough research has been conducted, the changes of brain structure and function caused by "re-domination" have been reported. This article is a review of the recent research progress on local structure, functional changes, and circuit reorganization of the cerebral cortex after SCI. Alterations of structure and electrical activity characteristics of brain neurons, features of brain functional reorganization, and regulation of brain functions by reconfigured information flow were also explored. The integration of brain function is the basis for the human body to exercise complex/fine movements and is intricately and widely regulated by information flow. Hence, its changes after SCI and treatments should be considered.
Collapse
Affiliation(s)
- Can Zhao
- Institute of Rehabilitation Engineering, China Rehabilitation Science Institute, Beijing, China
- School of Rehabilitation, Capital Medical University, Beijing, China
| | - Shu-Sheng Bao
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Meng Xu
- Department of Orthopedics, The First Medical Center of PLA General Hospital, Beijing, China
| | - Jia-Sheng Rao
- Beijing Key Laboratory for Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| |
Collapse
|