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جلد 23 شماره 1 صفحات 1-10 برگشت به فهرست نسخه ها
بررسی اثرات تحریک الکتریکی مستقیم مغزی بر شدت درد بیماران مبتلا به کمر‌درد مزمن: مروری نظام‌مند بر مطالعات گذشته
منا مسعودی ، سارا امیری ، نوشین مسعودیان ، فاطمه احسانی
چکیده:   (503 مشاهده)
هدف: کمر‌درد یکی از شایع‌ترین اختلالات عضلانی اسکلتی در جوامع امروزی محسوب می‌گردد که می‌تواند منجر به بروز درد مزمن و در نتیجه بروز تغییرات پاتولوژیک عملکرد مغز در اغلب بیماران گردد. بنابراین برطرف نمودن عوامل محیطی و مرکزی درد مزمن بیماران به‌دنبال ابتلا به کمردرد مزمن با به‌کارگیری از مداخلات موثر از اهمیت بالایی برخوردار است. بر اساس شواهد موجود، نتایج برخی از مطالعات نشان‌دهنده اثرات مثبت تحریکات الکتریکی مستقیم مغزی بر درد مزمن این بیماران می‌باشد، در حالی‌که برخی دیگر از مطالعات، اثرات معنی‌داری از این مداخله را بر درد مزمن بیماران مبتلا به کمردرد مزمن گزارش نکرده‌اند. هدف از مطالعه حاضر، مروری سیستماتیک بر مطالعاتی است که به بررسی اثر تحریکات الکتریکی مستقیم مغزی بر شدت درد بیماران مبتلا به کمردرد مزمن پرداخته‌اند.
مواد و روشها: جستجو در فاصله زمانی سال 2000 تا 2019 از بانک‌های اطلاعاتPubmed, Science Direct, Scopus,  MedLine, ProQuest, Cochrane, Google scholar, Embase, Ovid, WOS به عمل آمد. جهت بررسی کیفیت مقالات وارد شده از مقیاس PEDro استفاده شد.
یافتهها: از بین 177 مقاله، 7 مقاله که واجد شرایط مطالعه بودند، انتخاب گردیدند. از مهم‌ترین فاکتورهای تاثیرگذار در بروز تفاوت در نتایج مقالات، هم‌زمانی یا عدم هم‌زمانی استفاده از تحریکات الکتریکی مستقیم مغزی با درمان‌های محیطی صورت گرفته بود. بررسی و مرور نتایج مقالات نشان داد که تحریکات الکتریکی مغز به تنهایی اثر معنی‌داری بر شدت درد بیماران مبتلا به کمردرد مزمن نداشت و زمانی می‌توانست اثرگذاری معنی‌دار و ماندگاری بر کاهش شدت درد مزمن بیماران مبتلا به کمردرد داشته باشد که به همراه تحریکات الکتریکی محیطی و یا تمرینات استفاده گردد.
نتیجهگیری: تحریک الکتریکی مستقیم مغزی در ترکیب با مداخلات محیطی اثرات مثبت و ماندگاری بر روی پارامتر شدت درد در بیماران مبتلا به کمردرد مزمن دارد. بنابراین توصیه می‌گردد که جهت کنترل شدت درد بیماران مبتلا به کمردرد مزمن، استفاده از تحریکات الکتریکی مستقیم مغز با مداخلات محیطی همراه گردد.
 
واژه‌های کلیدی: کمردرد، تحریک الکتریکی مستقیم مغزی، درد مزمن، تحریک الکتریکی
متن کامل [PDF 766 kb]   (132 دریافت)    
نوع مطالعه: مروري | موضوع مقاله: مروري
دریافت: 1398/12/11 | پذیرش: 1399/4/25 | انتشار: 1399/10/23
فهرست منابع
1. [1] Svensson HO, Andersson GB, Johansson S, Wilhelmsson C, Vedin A. A retrospective study of low-back pain in 38- to 64-year-old women. Frequency of occurrence and impact on medical services. Spine (Phila Pa 1976) 1988; 13: 548-552. [DOI:10.1097/00007632-198805000-00019] [PMID]
2. [2] Cassidy JD, Cote P, Carroll LJ, Kristman V. Incidence and course of low back pain episodes in the general population. Spine (Phila Pa 1976) 2005; 30: 2817-2823. [DOI:10.1097/01.brs.0000190448.69091.53] [PMID]
3. [3] Wasiak R, Kim J, Pransky G. Work disability and costs caused by recurrence of low back pain: longer and more costly than in first episodes. Spine (Phila Pa 1976) 2006; 31: 219-225. [DOI:10.1097/01.brs.0000194774.85971.df] [PMID]
4. [4] Pelletier R, Higgins J, Bourbonnais D. Addressing neuroplastic changes in distributed areas of the nervous system associated with chronic musculoskeletal disorders. Phys Ther 2015; 95: 1582-1591. [DOI:10.2522/ptj.20140575] [PMID]
5. [5] Pelletier R, Higgins J, Bourbonnais D. Is neuroplasticity in the central nervous system the missing link to our understanding of chronic musculoskeletal disorders? BMC Musculoskelet Disord 2015; 16: 25. [DOI:10.1186/s12891-015-0480-y] [PMID] [PMCID]
6. [6] Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res 2008; 51: S225-S239. [DOI:10.1044/1092-4388(2008/018)]
7. [7] Apkarian AV, Hashmi JA, Baliki MN. Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. Pain 2011; 152: S49-64. [DOI:10.1016/j.pain.2010.11.010] [PMID] [PMCID]
8. [8] Gatchel RJ, Polatin PB, Mayer TG. The dominant role of psychosocial risk factors in the development of chronic low back pain disability. Spine (Phila Pa 1976) 1995; 20: 2702-2709. [DOI:10.1097/00007632-199512150-00011] [PMID]
9. [9] Linton SJ. A review of psychological risk factors in back and neck pain. Spine (Phila Pa 1976) 2000; 25: 1148-1156. [DOI:10.1097/00007632-200005010-00017] [PMID]
10. [10] Guclu DG, Guclu O, Ozaner A, Senormanci O, Konkan R. The relationship between disability, quality of life and fear-avoidance beliefs in patients with chronic low back pain. Turk Neurosurg 2012; 22: 724-731. [DOI:10.5137/1019-5149.JTN.6156-12.1] [PMID]
11. [11] Peters ML, Vlaeyen JW, Weber WE. The joint contribution of physical pathology, pain-related fear and catastrophizing to chronic back pain disability. Pain 2005; 113: 45-50. [DOI:10.1016/j.pain.2004.09.033] [PMID]
12. [12] Ehsani F, Arab AM, Salavati M, Hedayati R, Talimkhani I. Effect of exercise therapy in an unstable surface on muscle activity pattern in patients with low back pain: A systematic review. Koomesh 2015; 16: 495-504. (Persian).
13. [13] Ehsani F, Arab AM, Fatemy E. The relationship between abdominal muscle activity and pain, disability and fear of movement during standing postural tasks in females with chronic nonspecific low back pain. Koomesh 2016; 18: 250-257. (Persian).
14. [14] Puretic MB, Demarin V. Neuroplasticity mechanisms in the pathophysiology of chronic pain. Acta Clin Croat 2012; 51: 425-429.
15. [15] Radebold A, Cholewicki J, Polzhofer GK, Greene HS. Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine (Phila Pa 1976) 2001; 26: 724-730. [DOI:10.1097/00007632-200104010-00004] [PMID]
16. [16] Fujimoto H, Mihara M, Hattori N, Hatakenaka M, Kawano T, Yagura H, Miyai I, Mochizuki H. Cortical changes underlying balance recovery in patients with hemiplegic stroke. NeuroImage 2014; 85 Pt 1: 547-554. [DOI:10.1016/j.neuroimage.2013.05.014] [PMID]
17. [17] Kuo MF, Paulus W, Nitsche MA. Boosting focally-induced brain plasticity by dopamine. Cereb Cortex 2008; 18: 648-651. [DOI:10.1093/cercor/bhm098] [PMID]
18. [18] Monte-Silva K, Liebetanz D, Grundey J, Paulus W, Nitsche MA. Dosage-dependent non-linear effect of L-dopa on human motor cortex plasticity. J Physiol 2010; 588: 3415-3424. [DOI:10.1113/jphysiol.2010.190181] [PMID] [PMCID]
19. [19] Nitsche MA, Kuo MF, Grosch J, Bergner C, Monte-Silva K, Paulus W. D1-receptor impact on neuroplasticity in humans. J Neurosci 2009; 29: 2648-2653. [DOI:10.1523/JNEUROSCI.5366-08.2009] [PMID] [PMCID]
20. [20] O'Connell N, Cossar J, Marston L, Wand B, Bunce D, De Souza L, et al. Transcranial direct current stimulation of the motor cortex in the treatment of chronic nonspecific low back pain: a randomized, double-blind exploratory study. Clin J Pain 2013; 29: 26-34. [DOI:10.1097/AJP.0b013e318247ec09] [PMID]
21. [21] Straudi S, Buja S, Baroni A. The effects of transcranial direct current stimulation (tDCS) combined with group exercise treatment in subjects with chronic low back pain: a pilot randomized control trial. Clin Rehabil 2018; 32: 1348-1356. [DOI:10.1177/0269215518777881] [PMID]
22. [22] Schabrun S, Chipchase L, Jones E, Hodges P. P 258. Anodal tDCS and TENS for the treatment of chronic low back pain. Clin Neurophysiol 2013; 124: e186. [DOI:10.1016/j.clinph.2013.04.332]
23. [23] Mariano TY, Burgess FW, Bowker M, Kirschner J, Van't Wout-Frank M, Jones RN, et al. Transcranial direct current stimulation for affective symptoms and functioning in chronic low back pain: a pilot double-blinded, randomized, placebo-controlled trial. Pain Med 2019; 20: 1166-1177. [DOI:10.1093/pm/pny188] [PMID] [PMCID]
24. [24] Hazime FA, Baptista AF, de Freitas DG, Monteiro RL, Maretto RL, Hasue RH, Joao SMA. Treating low back pain with combined cerebral and peripheral electrical stimulation: A randomized, double-blind, factorial clinical trial. Eur J Pain 2017; 21: 1132-1143. [DOI:10.1002/ejp.1037] [PMID]
25. [25] Luedtke K, Rushton A, Wright C, Juergens TP, Mueller G, May A. Effectiveness of anodal transcranial direct current stimulation in patients with chronic low back pain: Design, method and protocol for a randomised controlled trial. BMC Musculoskelet Disord 2011; 12: 290. [DOI:10.1186/1471-2474-12-290] [PMID] [PMCID]
26. [26] Reidler JS, Mendonca ME, Santana MB, Wang X, Lenkinski R, Motta AF, et al. Effects of motor cortex modulation and descending inhibitory systems on pain thresholds in healthy subjects. J Pain 2012; 13: 450-458. [DOI:10.1016/j.jpain.2012.01.005] [PMID]
27. [27] Luedtke K, May A, Jurgens TP. No effect of a single session of transcranial direct current stimulation on experimentally induced pain in patients with chronic low back pain--an exploratory study. PLoS One 2012; 7: e48857. [DOI:10.1371/journal.pone.0048857] [PMID] [PMCID]
28. [28] Luedtke K, Rushton A, Wright C, Jurgens T, Polzer A, Mueller G, May A. Effectiveness of transcranial direct current stimulation preceding cognitive behavioural management for chronic low back pain: sham controlled double blinded randomised controlled trial. BMJ 2015; 350: h1640. [DOI:10.1136/bmj.h1640] [PMID] [PMCID]
29. [29] O'connell NE, Cossar J, Marston L, Wand BM, Bunce D, De Souza LH, et al. Transcranial direct current stimulation of the motor cortex in the treatment of chronic nonspecific low back pain: a randomized, double-blind exploratory study. Clin J Pain 2013; 29: 26-34. [DOI:10.1097/AJP.0b013e318247ec09] [PMID]
30. [30] Schabrun SM, Jones E, Cancino EL, Hodges PW. Targeting chronic recurrent low back pain from the top-down and the bottom-up: a combined transcranial direct current stimulation and peripheral electrical stimulation intervention. Brain Stimul 2014; 7: 451-459. [DOI:10.1016/j.brs.2014.01.058] [PMID]
31. [31] Umar A, Bin Simbak N, Raj NB, Ahmad A, Hanif S, Muhammad AH, Mahadeva Rao US. Effect of combined brain and back muscle stimulations on level of physical disability among chronic low back pain patients. Res J Pharmacy Technol 2017; 10: 3326-3330. [DOI:10.5958/0974-360X.2017.00590.X]
32. [32] Ohara S, Weiss N, Lenz FA. Microstimulation in the region of the human thalamic principal somatic sensory nucleus evokes sensations like those of mechanical stimulation and movement. J Neurophysiol 2004; 91: 736-745. [DOI:10.1152/jn.00648.2003] [PMID]
33. [33] Mesulam MM, Mufson EJ. Insula of the old world monkey. III: Efferent cortical output and comments on function. J Comp Neurol 1982; 212: 38-52. [DOI:10.1002/cne.902120104] [PMID]
34. [34] Jones EG, Coulter JD, Hendry SH. Intracortical connectivity of architectonic fields in the somatic sensory, motor and parietal cortex of monkeys. J Comp Neurol 1978; 181: 291-347. [DOI:10.1002/cne.901810206] [PMID]
35. [1] Svensson HO, Andersson GB, Johansson S, Wilhelmsson C, Vedin A. A retrospective study of low-back pain in 38- to 64-year-old women. Frequency of occurrence and impact on medical services. Spine (Phila Pa 1976) 1988; 13: 548-552. [DOI:10.1097/00007632-198805000-00019] [PMID]
36. [2] Cassidy JD, Cote P, Carroll LJ, Kristman V. Incidence and course of low back pain episodes in the general population. Spine (Phila Pa 1976) 2005; 30: 2817-2823. [DOI:10.1097/01.brs.0000190448.69091.53] [PMID]
37. [3] Wasiak R, Kim J, Pransky G. Work disability and costs caused by recurrence of low back pain: longer and more costly than in first episodes. Spine (Phila Pa 1976) 2006; 31: 219-225. [DOI:10.1097/01.brs.0000194774.85971.df] [PMID]
38. [4] Pelletier R, Higgins J, Bourbonnais D. Addressing neuroplastic changes in distributed areas of the nervous system associated with chronic musculoskeletal disorders. Phys Ther 2015; 95: 1582-1591. [DOI:10.2522/ptj.20140575] [PMID]
39. [5] Pelletier R, Higgins J, Bourbonnais D. Is neuroplasticity in the central nervous system the missing link to our understanding of chronic musculoskeletal disorders? BMC Musculoskelet Disord 2015; 16: 25. [DOI:10.1186/s12891-015-0480-y] [PMID] [PMCID]
40. [6] Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res 2008; 51: S225-S239. [DOI:10.1044/1092-4388(2008/018)]
41. [7] Apkarian AV, Hashmi JA, Baliki MN. Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. Pain 2011; 152: S49-64. [DOI:10.1016/j.pain.2010.11.010] [PMID] [PMCID]
42. [8] Gatchel RJ, Polatin PB, Mayer TG. The dominant role of psychosocial risk factors in the development of chronic low back pain disability. Spine (Phila Pa 1976) 1995; 20: 2702-2709. [DOI:10.1097/00007632-199512150-00011] [PMID]
43. [9] Linton SJ. A review of psychological risk factors in back and neck pain. Spine (Phila Pa 1976) 2000; 25: 1148-1156. [DOI:10.1097/00007632-200005010-00017] [PMID]
44. [10] Guclu DG, Guclu O, Ozaner A, Senormanci O, Konkan R. The relationship between disability, quality of life and fear-avoidance beliefs in patients with chronic low back pain. Turk Neurosurg 2012; 22: 724-731. [DOI:10.5137/1019-5149.JTN.6156-12.1] [PMID]
45. [11] Peters ML, Vlaeyen JW, Weber WE. The joint contribution of physical pathology, pain-related fear and catastrophizing to chronic back pain disability. Pain 2005; 113: 45-50. [DOI:10.1016/j.pain.2004.09.033] [PMID]
46. [12] Ehsani F, Arab AM, Salavati M, Hedayati R, Talimkhani I. Effect of exercise therapy in an unstable surface on muscle activity pattern in patients with low back pain: A systematic review. Koomesh 2015; 16: 495-504. (Persian).
47. [13] Ehsani F, Arab AM, Fatemy E. The relationship between abdominal muscle activity and pain, disability and fear of movement during standing postural tasks in females with chronic nonspecific low back pain. Koomesh 2016; 18: 250-257. (Persian).
48. [14] Puretic MB, Demarin V. Neuroplasticity mechanisms in the pathophysiology of chronic pain. Acta Clin Croat 2012; 51: 425-429.
49. [15] Radebold A, Cholewicki J, Polzhofer GK, Greene HS. Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine (Phila Pa 1976) 2001; 26: 724-730. [DOI:10.1097/00007632-200104010-00004] [PMID]
50. [16] Fujimoto H, Mihara M, Hattori N, Hatakenaka M, Kawano T, Yagura H, Miyai I, Mochizuki H. Cortical changes underlying balance recovery in patients with hemiplegic stroke. NeuroImage 2014; 85 Pt 1: 547-554. [DOI:10.1016/j.neuroimage.2013.05.014] [PMID]
51. [17] Kuo MF, Paulus W, Nitsche MA. Boosting focally-induced brain plasticity by dopamine. Cereb Cortex 2008; 18: 648-651. [DOI:10.1093/cercor/bhm098] [PMID]
52. [18] Monte-Silva K, Liebetanz D, Grundey J, Paulus W, Nitsche MA. Dosage-dependent non-linear effect of L-dopa on human motor cortex plasticity. J Physiol 2010; 588: 3415-3424. [DOI:10.1113/jphysiol.2010.190181] [PMID] [PMCID]
53. [19] Nitsche MA, Kuo MF, Grosch J, Bergner C, Monte-Silva K, Paulus W. D1-receptor impact on neuroplasticity in humans. J Neurosci 2009; 29: 2648-2653. [DOI:10.1523/JNEUROSCI.5366-08.2009] [PMID] [PMCID]
54. [20] O'Connell N, Cossar J, Marston L, Wand B, Bunce D, De Souza L, et al. Transcranial direct current stimulation of the motor cortex in the treatment of chronic nonspecific low back pain: a randomized, double-blind exploratory study. Clin J Pain 2013; 29: 26-34. [DOI:10.1097/AJP.0b013e318247ec09] [PMID]
55. [21] Straudi S, Buja S, Baroni A. The effects of transcranial direct current stimulation (tDCS) combined with group exercise treatment in subjects with chronic low back pain: a pilot randomized control trial. Clin Rehabil 2018; 32: 1348-1356. [DOI:10.1177/0269215518777881] [PMID]
56. [22] Schabrun S, Chipchase L, Jones E, Hodges P. P 258. Anodal tDCS and TENS for the treatment of chronic low back pain. Clin Neurophysiol 2013; 124: e186. [DOI:10.1016/j.clinph.2013.04.332]
57. [23] Mariano TY, Burgess FW, Bowker M, Kirschner J, Van't Wout-Frank M, Jones RN, et al. Transcranial direct current stimulation for affective symptoms and functioning in chronic low back pain: a pilot double-blinded, randomized, placebo-controlled trial. Pain Med 2019; 20: 1166-1177. [DOI:10.1093/pm/pny188] [PMID] [PMCID]
58. [24] Hazime FA, Baptista AF, de Freitas DG, Monteiro RL, Maretto RL, Hasue RH, Joao SMA. Treating low back pain with combined cerebral and peripheral electrical stimulation: A randomized, double-blind, factorial clinical trial. Eur J Pain 2017; 21: 1132-1143. [DOI:10.1002/ejp.1037] [PMID]
59. [25] Luedtke K, Rushton A, Wright C, Juergens TP, Mueller G, May A. Effectiveness of anodal transcranial direct current stimulation in patients with chronic low back pain: Design, method and protocol for a randomised controlled trial. BMC Musculoskelet Disord 2011; 12: 290. [DOI:10.1186/1471-2474-12-290] [PMID] [PMCID]
60. [26] Reidler JS, Mendonca ME, Santana MB, Wang X, Lenkinski R, Motta AF, et al. Effects of motor cortex modulation and descending inhibitory systems on pain thresholds in healthy subjects. J Pain 2012; 13: 450-458. [DOI:10.1016/j.jpain.2012.01.005] [PMID]
61. [27] Luedtke K, May A, Jurgens TP. No effect of a single session of transcranial direct current stimulation on experimentally induced pain in patients with chronic low back pain--an exploratory study. PLoS One 2012; 7: e48857. [DOI:10.1371/journal.pone.0048857] [PMID] [PMCID]
62. [28] Luedtke K, Rushton A, Wright C, Jurgens T, Polzer A, Mueller G, May A. Effectiveness of transcranial direct current stimulation preceding cognitive behavioural management for chronic low back pain: sham controlled double blinded randomised controlled trial. BMJ 2015; 350: h1640. [DOI:10.1136/bmj.h1640] [PMID] [PMCID]
63. [29] O'connell NE, Cossar J, Marston L, Wand BM, Bunce D, De Souza LH, et al. Transcranial direct current stimulation of the motor cortex in the treatment of chronic nonspecific low back pain: a randomized, double-blind exploratory study. Clin J Pain 2013; 29: 26-34. [DOI:10.1097/AJP.0b013e318247ec09] [PMID]
64. [30] Schabrun SM, Jones E, Cancino EL, Hodges PW. Targeting chronic recurrent low back pain from the top-down and the bottom-up: a combined transcranial direct current stimulation and peripheral electrical stimulation intervention. Brain Stimul 2014; 7: 451-459. [DOI:10.1016/j.brs.2014.01.058] [PMID]
65. [31] Umar A, Bin Simbak N, Raj NB, Ahmad A, Hanif S, Muhammad AH, Mahadeva Rao US. Effect of combined brain and back muscle stimulations on level of physical disability among chronic low back pain patients. Res J Pharmacy Technol 2017; 10: 3326-3330. [DOI:10.5958/0974-360X.2017.00590.X]
66. [32] Ohara S, Weiss N, Lenz FA. Microstimulation in the region of the human thalamic principal somatic sensory nucleus evokes sensations like those of mechanical stimulation and movement. J Neurophysiol 2004; 91: 736-745. [DOI:10.1152/jn.00648.2003] [PMID]
67. [33] Mesulam MM, Mufson EJ. Insula of the old world monkey. III: Efferent cortical output and comments on function. J Comp Neurol 1982; 212: 38-52. [DOI:10.1002/cne.902120104] [PMID]
68. [34] Jones EG, Coulter JD, Hendry SH. Intracortical connectivity of architectonic fields in the somatic sensory, motor and parietal cortex of monkeys. J Comp Neurol 1978; 181: 291-347. [DOI:10.1002/cne.901810206] [PMID]
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Masoudi M, Amiri S, Masoudian N, Ehsani F. Effects of transcranial direct current stimulation on pain intensity in patients with chronic low back pain: a systematic review of literature. Koomesh. 2021; 23 (1) :1-10
URL: http://koomeshjournal.semums.ac.ir/article-1-6259-fa.html

مسعودی منا، امیری سارا، مسعودیان نوشین، احسانی فاطمه. بررسی اثرات تحریک الکتریکی مستقیم مغزی بر شدت درد بیماران مبتلا به کمر‌درد مزمن: مروری نظام‌مند بر مطالعات گذشته. كومش. 1399; 23 (1) :1-10

URL: http://koomeshjournal.semums.ac.ir/article-1-6259-fa.html



جلد 23، شماره 1 - ( زمستان 1399 ) برگشت به فهرست نسخه ها
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