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Brain mechanisms of pain relief by transcutaneous electrical nerve stimulation: A functional magnetic resonance imaging study

Title
Brain mechanisms of pain relief by transcutaneous electrical nerve stimulation: A functional magnetic resonance imaging study
Author
이종민
Keywords
DORSOLATERAL PREFRONTAL CORTEX; MIDBRAIN PERIAQUEDUCTAL GRAY; POSTOPERATIVE PAIN; CONTROLLED-TRIAL; SEX-DIFFERENCES; MEDIAN NERVE; DOUBLE-BLIND; PERCEPTION; MODULATION; ANALGESIA
Issue Date
2016-01
Publisher
WILEY-BLACKWELL
Citation
EUROPEAN JOURNAL OF PAIN, v. 20, NO 1, Page. 92-105
Abstract
BackgroundAlthough the exact mechanism of TENS pain relief is unknown, it is believed that TENS impulses interrupt nociceptive signals at the dorsal horn of the spinal cord. AimsTo evaluate the hypotheses that during pain caused by noxious stimuli, brain responses, temporal summation and brain functional connectivity are modulated by TENS, and that mechanisms of pain relief by TENS differ between men and women. MethodsDuring fMRI scanning, the same noxious stimuli were delivered to each participant in pain-only and pain+TENS conditions. In the pain-only condition, noxious stimuli were presented without TENS. In the pain+TENS condition, participants received noxious stimuli and TENS concurrently. Participants were initially presented with TENS at an intensity that was just below that causing discomfort. TENS intensity was presented in a step-wise fashion to prevent temporal summation from repetitive noxious stimuli. ResultsPain and unpleasantness ratings were significantly higher in the pain-only than the pain+TENS condition. With non-painful TENS, primary and secondary somatosensory and parietal cortices were activated, and temporal summation from repetitive noxious stimuli was prevented. Periaqueductal gray (PAG) and lateral prefrontal cortex functional connectivity was increased by TENS, and modulated by testosterone and cortisol. Women reported greater pain during TENS than men, and showed greater activation in the temporoparietal junction cortex and increased PAG functional connectivity with the orbitofrontal cortex. ConclusionTENS led to pain reduction, probably due to activation of the descending pain-inhibitory pathway, indicating that this TENS method may be applied in clinical practice.
URI
http://onlinelibrary.wiley.com/doi/10.1002/ejp.696/abstracthttp://hdl.handle.net/20.500.11754/31468
ISSN
1090-3801; 1532-2149
DOI
10.1002/ejp.696
Appears in Collections:
COLLEGE OF ENGINEERING[S](공과대학) > ELECTRICAL AND BIOMEDICAL ENGINEERING(전기·생체공학부) > Articles
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