한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제16권1호
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  • Pages.445-452
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  • 2015
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  • 1975-4701(pISSN)
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  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
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배외측전전두엽피질 영역에 경두개직류전류자극이 감각기능에 미치는 영향

Changes in the Sensory Function after Transcranial Direct Stimulation on Dorsolateral Prefrontal Cortex Area

  • 민동기 (계명대학교 동산병원 재활의학교실)
  • Min, Dong-Ki (Dept. of Rehabilitation Medicine, Colleage of Medicine, Keimyung University, Dongsan Medical Center)
  • 투고 : 2014.10.31
  • 심사 : 2015.01.08
  • 발행 : 2015.01.31
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초록

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. 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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참고문헌

  1. Fregni F, Freedman S, Pascual-Leone A. Recent advances in the treatment oh chronic pain with non-invasive brain stimulation techniques. Lancet Neurology. 6: 188-191, 2007. DOI: http://dx.doi.org/10.1016/S1474-4422(07)70032-7
  2. Wagner T, Fregni F, Fecteau S, Grodzinsky A, Zahn M, Pascual-Leone A: Transcranial direct current stimulation: a computer-based human model study. Neuroimage. 35: 1113-1124, 2007. DOI: http://dx.doi.org/10.1016/j.neuroimage.2007.01.027
  3. Vines BW, Cerruti C, Schlaug G: Dual-hemisphere tDCS facilitates greater improvements for healthy subjects' non-dominant hand compared to uni-hemisphere stimulation. BMC Neurosci. 9: 103. 2008. DOI: http://dx.doi.org/10.1186/1471-2202-9-103
  4. Nitsche MA, Paulus W: Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans. Neurology. 57: 1899-1901. 2001. DOI: http://dx.doi.org/10.1212/WNL.57.10.1899
  5. Priori A, Berardelli A, Rona S, Accornero N, Manfredi M: Polarization of the human motor cortex through the scalp. Neuroreport. 9: 2257-2260. 1998. DOI: http://dx.doi.org/10.1097/00001756-199807130-00020
  6. Nitsche MA, Paulus W: Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol. 527: 633-9. 2000. DOI: http://dx.doi.org/10.1111/j.1469-7793.2000.t01-1-00633.x
  7. Iyer RB, Silaghi-Dumitrescu R, Kurtz DM, Jr., Lanzilotta WN: High-resolution crystal structures of Desulfovibrio vulgaris (Hildenborough) nigerythrin: facile, redox-dependent iron movement, domain interface variability, and peroxidase activity in the rubrerythrins. J Biol Inorg Chem. 10: 407-416. 2005. DOI: http://dx.doi.org/10.1007/s00775-005-0667-z
  8. Poreisz C, Boros K, Antal A, Paulus W: Safety aspects of transcranial direct current stimulation concerning healthy subjects and patients. Brain Res Bull. 72: 208-14. 2007. DOI: http://dx.doi.org/10.1016/j.brainresbull.2007.01.004
  9. Antal A, Terney D, Poreisz C, Paulus W: Towards unravelling task-related modulations of neuroplastic changes induced in the human motor cortex. Eur J Neurosci. 26: 2687-91. 2007. DOI: http://dx.doi.org/10.1111/j.1460-9568.2007.05896.x
  10. Fecteau S, Pascual-Leone A, Zald DH, Liguori P, Theoret H, Boggio PS, et al.: Activation of prefrontal cortex by transcranial direct current stimulation reduces appetite for risk during ambiguous decision making. J Neurosci. 27: 6212-6218. 2007. DOI: http://dx.doi.org/10.1523/JNEUROSCI.3283-07.2007
  11. Floel A, Rosser N, Michka O, Knecht S, Breitenstein C: Noninvasive brain stimulation improves language learning. J Cogn Neurosci .20: 1415-22. 2008. DOI: http://dx.doi.org/10.1162/jocn.2008.20098
  12. Fregni F, Boggio PS, Nitsche M, Bermpohl F, Antal A, Feredoes E, et al.: Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory. Exp Brain Res. 166: 23-30. 2005. DOI: http://dx.doi.org/10.1007/s00221-005-2334-6
  13. Fregni F, Freedman S, Pascual-Leone A: Recent advances in the treatment of chronic pain with non-invasive brain stimulation techniques. Lancet Neurol. 6: 188-91. 2007. DOI: http://dx.doi.org/10.1016/S1474-4422(07)70032-7
  14. Boggio PS, Rigonatti SP, Ribeiro RB, Myczkowski ML, Nitsche MA, Pascual-Leone A, et al.: A randomized, double-blind clinical trial on the efficacy of cortical direct current stimulation for the treatment of major depression. Int J Neuropsychopharmacol. 11: 249-254. 2008. DOI: http://dx.doi.org/10.1017/S1461145707007833
  15. Fregni F, Gimenes R, Valle AC, Ferreira MJ, Rocha RR, Natalle L, et al.: A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Arthritis Rheum. 54: 3988-98. 2006. DOI: http://dx.doi.org/10.1002/art.22195
  16. Fregni F, Boggio PS, Lima MC, Ferreira MJ, Wagner T, Rigonatti SP, et al.: A sham-controlled, phase II trial of transcranial direct current stimulation for the treatment of central pain in traumatic spinal cord injury. Pain. 122: 197-209. 2006. DOI: http://dx.doi.org/10.1016/j.pain.2006.02.023
  17. Silva G, Miksad R, Freedman SD, Pascual-Leone A, Jain S, Gomes DL, et al.: Treatment of cancer pain with noninvasive brain stimulation. J Pain Symptom Manage. 34: 342-345. 2007. DOI: http://dx.doi.org/10.1016/j.jpainsymman.2007.06.002
  18. Boggio PS, Zaghi S, Lopes M, Fregni F: Modulatory effects of anodal transcranial direct current stimulation on perception and pain thresholds in healthy volunteers. Eur J Neurol. 15: 1124-1130. 2008. DOI: http://dx.doi.org/10.1111/j.1468-1331.2008.02270.x
  19. Guidelines in electrodiagnostic medicine. Technology review: the Neurometer Current Perception Threshold (CPT). Muscle Nerve Suppl. 8: S247-59. 1999.
  20. Katims JJ, Naviasky EH, Rendell MS, Ng LK, Bleecker ML: Constant current sine wave transcutaneous nerve stimulation for the evaluation of peripheral neuropathy. Arch Phys Med Rehabil. 68: 210-3. 1987.
  21. Kodama M, Aono K, Masakado Y: Changes in sensory functions after low-frequency repetitive transcranial magnetic stimulation over the motor cortex. Tokai J Exp Clin Med. 34: 122-9. 2009.
  22. Herwig U, Lampe Y, Juengling FD, Wunderlich A, Walter H, Spitzer M, et al.: Add-on rTMS for treatment of depression: a pilot study using stereotaxic coil-navigation according to PET data. J Psychiatr Res. 37: 267-75. 2003. DOI: http://dx.doi.org/10.1016/S0022-3956(03)00042-6
  23. Rossi S, Cappa SF, Babiloni C, Pasqualetti P, Miniussi C, Carducci F, et al.: Prefrontal [correction of Prefontal] cortex in long-term memory: an "interference" approach using magnetic stimulation. Nat Neurosci. 4: 948-52. 2001. DOI: http://dx.doi.org/10.1038/nn0901-948
  24. Gandiga PC, Hummel FC, Cohen LG: Transcranial DC stimulation (tDCS): a tool for double-blind sham-controlled clinical studies in brain stimulation. Clin Neurophysiol. 117: 845-50. 2006. DOI: http://dx.doi.org/10.1016/j.clinph.2005.12.003
  25. Freund W, Stuber G, Wunderlich AP, Schmitz B: Cortical correlates of perception and suppression of electrically induced pain. Somatosens Mot Res. 24: 203-12. 2007. DOI: http://dx.doi.org/10.1080/08990220701723636
  26. Avery DH, Holtzheimer PE, 3rd, Fawaz W, Russo J, Neumaier J, Dunner DL, et al.: Transcranial magnetic stimulation reduces pain in patients with major depression: a sham-controlled study. J Nerv Ment Dis. 195: 378-381. 2007.
  27. Lorenz J, Minoshima S, Casey KL: Keeping pain out of mind: the role of the dorsolateral prefrontal cortex in pain modulation. Brain. 126: 1079-1091. 2007. DOI: http://dx.doi.org/10.1093/brain/awg102
  28. Bar KJ, Wagner G, Koschke M, Boettger S, Boettger MK, Schlosser R, et al.: Increased prefrontal activation during pain perception in major depression. Biol Psychiatry. 62: 1281-1287. 2007. DOI: http://dx.doi.org/10.1016/j.biopsych.2007.02.011
  29. Borckardt JJ, Smith AR, Reeves ST, Weinstein M, Kozel FA, Nahas Z, et al.: Fifteen minutes of left prefrontal repetitive transcranial magnetic stimulation acutely increases thermal pain thresholds in healthy adults. Pain Res Manag. 12: 287-290. 2007. https://doi.org/10.1155/2007/741897
  30. Godinho F, Magnin M, Frot M, Perchet C, Garcia-Larrea L: Emotional modulation of pain: is it the sensation or what we recall? J Neurosci. 26: 11454-11461. 2006. DOI: http://dx.doi.org/10.1523/JNEUROSCI.2260-06.2006
  31. Boggio PS, Zaghi S, Fregni F: Modulation of emotions associated with images of human pain using anodal transcranial direct current stimulation(tDCS). Neuropsychologia. 47: 212-217. 2009. DOI: http://dx.doi.org/10.1016/j.neuropsychologia.2008.07.022
  32. Liu SS, Gerancher JC, Bainton BG, Kopacz DJ, Carpenter RL: The effects of electrical stimulation at different frequencies on perception and pain in human volunteers: epidural versus intravenous administration of fentanyl. Anesth Analg. 82: 98-102. 1996. DOI: http://dx.doi.org/10.1213/00000539-199601000-00017