경두개직류전류자극(tDCS)은 낮은 직류 전류 강도를 사용하여 대뇌피질의 자발적인 신경학적 활동의 흥분성을 증가 또는 감소시키는 신경조절 기법이다. 본 연구의 목적은 tDCS를 적용한 후 다양한 감각 기능의 변화를 측정하는데 있다. tDCS의 효과를 측정하기 위해 CPT 검사를 50명의 건강한 대상자에게 단일 기간(8월4일에서 8월29일), 단일 공간, 단일 맹검법으로 무작위 배정하였다. 신경전도검사는 우세 손의 말초신경 병변을 구별하기 위해 정중 감각과 운동신경을 측정하였다. 대상자들은 각 25명 씩 대뇌피질의 DLPFC의 tDCS 자극군과 대뇌피질의 DLPFC의 tDCS 위자극군으로 2개의 다른 조건 아래서 1 mA의 전류강도로 15분씩 양극 tDCS로 적용하였다. 촉각, 빠른 통증과 느린 통증을 각각 평가하기 위해 우세한 제 2수지에 2000, 250, 그리고 5 Hz의 주파수로 CPT 검사인 Neurometer$^{(R)}$를 이용하여 수치들을 기록하였다. DLPFC의 양극 tDCS 자극군의 CPT 수치들에서는 250과 5 Hz에서 통계적으로 유의한 증가를 보였다. 양극 tDCS 위자극군의 모든 CPT 수치들은 감소하였다. 이러한 결과는 DLPFC의 양극 tDCS가 건강한 대상자들의 감각 지각과 통증 역치들을 조절할 수 있다는 것을 보여준다. 따라서 본 연구는 재활과 통증 치료 분야에서 유용한 치료 방법 중 하나로 제시할 수 있을 것으로 생각한다.
경두개직류전류자극(tDCS)은 낮은 직류 전류 강도를 사용하여 대뇌피질의 자발적인 신경학적 활동의 흥분성을 증가 또는 감소시키는 신경조절 기법이다. 본 연구의 목적은 tDCS를 적용한 후 다양한 감각 기능의 변화를 측정하는데 있다. tDCS의 효과를 측정하기 위해 CPT 검사를 50명의 건강한 대상자에게 단일 기간(8월4일에서 8월29일), 단일 공간, 단일 맹검법으로 무작위 배정하였다. 신경전도검사는 우세 손의 말초신경 병변을 구별하기 위해 정중 감각과 운동신경을 측정하였다. 대상자들은 각 25명 씩 대뇌피질의 DLPFC의 tDCS 자극군과 대뇌피질의 DLPFC의 tDCS 위자극군으로 2개의 다른 조건 아래서 1 mA의 전류강도로 15분씩 양극 tDCS로 적용하였다. 촉각, 빠른 통증과 느린 통증을 각각 평가하기 위해 우세한 제 2수지에 2000, 250, 그리고 5 Hz의 주파수로 CPT 검사인 Neurometer$^{(R)}$를 이용하여 수치들을 기록하였다. DLPFC의 양극 tDCS 자극군의 CPT 수치들에서는 250과 5 Hz에서 통계적으로 유의한 증가를 보였다. 양극 tDCS 위자극군의 모든 CPT 수치들은 감소하였다. 이러한 결과는 DLPFC의 양극 tDCS가 건강한 대상자들의 감각 지각과 통증 역치들을 조절할 수 있다는 것을 보여준다. 따라서 본 연구는 재활과 통증 치료 분야에서 유용한 치료 방법 중 하나로 제시할 수 있을 것으로 생각한다.
Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. ...
Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. A single-center, single-blinded, randomized trial was conducted to determine the effect of a single session (August 4 to August 29) of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies (NCS) were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1mA for 15 minutes under two different conditions, with 25 subjects in each group. The conditions were as follows: tDCS on the dorsolateral prefrontal cortex (DLPFC) and sham tDCS on DLPFC. The parameters of the CPT was recorded with a Neurometer$^{(R)}$ at frequencies of 2000, 250 and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure the CPT values of the DLPFC in the anodal tDCS group, the values increased significantly in all of 250 and 5 Hz. All CPT values decreased for the sham tDCS. These results showed that DLPFC anodal tDCS can modulate the sensory perception and pain thresholds in healthy adult volunteers. This study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.
Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. A single-center, single-blinded, randomized trial was conducted to determine the effect of a single session (August 4 to August 29) of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies (NCS) were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1mA for 15 minutes under two different conditions, with 25 subjects in each group. The conditions were as follows: tDCS on the dorsolateral prefrontal cortex (DLPFC) and sham tDCS on DLPFC. The parameters of the CPT was recorded with a Neurometer$^{(R)}$ at frequencies of 2000, 250 and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure the CPT values of the DLPFC in the anodal tDCS group, the values increased significantly in all of 250 and 5 Hz. All CPT values decreased for the sham tDCS. These results showed that DLPFC anodal tDCS can modulate the sensory perception and pain thresholds in healthy adult volunteers. This study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.
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제안 방법
This test selectively stimulates the peripheral nervous fibers--the large myelinated nerve Aβ, small myelinated nerve Aδ, and unmyelinated nerve C in the form of a sine curve at 2000 Hz, 250 Hz, and 5 Hz. It is possible to quantify the sensory threshold by electrical stimulation through the skin with three different frequencies, and therefore the test is used for diagnosis of various neuropathies, including peripheral neuropathy[19,20]. Kodama et al.
The CPT test was conducted with a Neurometer® (Neurotron, Baltimore, USA).
This study applied tDCS to the DLPFC, and measured changes in the peripheral sensory nerves, thereby investigating the effects of tDCS on sensory nerves, and providing supportive materials for its clinical use. The healthy subjects were divided into an anodal tDCS group and a sham tDCS group for application of tDCS. The CPT values in Aδ and C nerve fibers of the DLPFC increased statistically significantly in the tDCS group.
The subjects sat comfortably on a chair, a thin layer of conductive gel was applied, and then a pair of gold electrodes was attached with an unstretched tape to the distal part of the distal interphalangeal joint of the second finger(Figure 1). The subjects were randomly and equally assigned to a control group or to an experimental group, and then the CPT values were measured in a single blind-method and in manual mode. A current with frequencies of 2000 Hz, 250 Hz, 5 Hz was applied to the subjects with an intensity of stimulation starting from 0.
Boggio et al[18] applied anodal tDCS to the diverse cerebral cortex areas of healthy adults with 2 mA current for five minutes and measured their peripheral electrical stimulation; The result was only the pain threshold significantly rose in the DLPFC area. Their study applied dual tDCS to the M1 and DLPFC and presented its simultaneous effects of decreasing discomfort and pain in chronic spinal cord damage patients. The present study as well obtained a statistically significant result of tDCS application to the M1 and DLPFC in the CPT test, clarifying the ground for clinical use of tDCS for patients with pain.
[21] did. Therefore, this study applied tDCS to the M1 of the cerebral cortex and measured changes in the peripheral sensory nerves, thereby clarifying the effects of tDCS on sensory nerves and providing evidential material for its clinical application.
This study applied tDCS to the DLPFC, and measured changes in the peripheral sensory nerves, thereby investigating the effects of tDCS on sensory nerves, and providing supportive materials for its clinical use. The healthy subjects were divided into an anodal tDCS group and a sham tDCS group for application of tDCS.
The present study as well obtained a statistically significant result of tDCS application to the M1 and DLPFC in the CPT test, clarifying the ground for clinical use of tDCS for patients with pain. This study examined changes in each sensory nerve fiber through a CPT test that had not been inquired into in previous research, providing a ground to clarify sensory the function control mechanism of tDCS stimulation and its effects.
Much research is being performed on diverse application areas and effects of tDCS. This study measured changes according to tDCS stimulation and the kinds of peripheral sensory nerve fibers, thereby laying the clinical foundations for application of tDCS to treatment of pain through different mechanisms. tDCS may be presented as one of the useful treatment methods in rehabilitation and pain treatment.
대상 데이터
The subjects were healthy, right-handed adults who did not have a history of brain damage or neurological abnormality, and did not exhibit any problem in electroneurography. The number of subjects was 50(male:37, female:13) and they were equally and randomly assigned to either a tDCS group or a sham tDCS group.
The tDCS device, Phoresor Ⅱ Auto (PM850, IOMEDⓇ, Salt Lake City, Utah, USA) was used. The size of the two sponge electrodes attached to the scalp was 25 ㎠(5㎝x5㎝) and their current density was 0.
데이터처리
0K for windows (SPSS Inc, Chicago, IL, USA) and as a normality test the Kolmogorov-Smirov/ Shapiro-Wilk test was carried out. A paired t-test was performed to compare the DLPFC between, prior to, and after the intervention in the tDCS group and the sham tDCS group. A statistical significance level was set at p<.
In this study, statistical analysis was conducted with SPSS 19.0K for windows (SPSS Inc, Chicago, IL, USA) and as a normality test the Kolmogorov-Smirov/ Shapiro-Wilk test was carried out. A paired t-test was performed to compare the DLPFC between, prior to, and after the intervention in the tDCS group and the sham tDCS group.
성능/효과
In the test to measure CPT values of the DLPFC in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger increased in all of 2000 Hz, 250 Hz, and 5 Hz(p<.05).
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