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Abstract：
Burn survivors experience myriad associated symptoms such as pain, pruritus, fatigue, impaired motor strength, post-traumatic stress, depression, anxiety, and sleep disturbance. Many of these symptoms are common and remain chronic, despite current standard of care. One potential novel intervention to target these post burn symptoms is transcranial direct current stimulation (tDCS). tDCS is a non-invasive brain stimulation (NIBS) technique that modulates neural excitability of a specific target or neural network. The aim of this work is to review the neural circuits of the aforementioned clinical sequelae associated with burn injuries and to provide a scientific rationale for specific NIBS targets that can potentially treat these conditions. We ran a systematic review, following the PRISMA statement, of tDCS effects on burn symptoms. Only three studies matched our criteria. One was a feasibility study assessing cortical plasticity in chronic neuropathic pain following burn injury, one looked at the effects of tDCS to reduce pain anxiety during burn wound care, and one assessed the effects of tDCS to manage pain and pruritus in burn survivors. Current literature on NIBS in burn remains limited, only a few trials have been conducted. Based on our review and results in other populations suffering from similar symptoms as patients with burn injuries, three main areas were selected: the prefrontal region, the parietal area and the motor cortex. Based on the importance of the prefrontal cortex in the emotional component of pain and its implication in various psychosocial symptoms, targeting this region may represent the most promising target. Our review of the neural circuitry involved in post burn symptoms and suggested targeted areas for stimulation provide a spring board for future study initiatives.
摘要：
烧伤幸存者经历无数相关症状，如疼痛，瘙痒,疲劳,运动强度受损，创伤后应激,抑郁症,焦虑,和睡眠障碍。这些症状中的许多是常见的，并且仍然是慢性的，尽管目前的护理标准。针对这些烧伤后症状的一种潜在的新型干预措施是经颅直流电刺激（tDCS）。tDCS是一种非侵入性脑刺激（NIBS）技术，可调节特定目标或神经网络的神经兴奋性。这项工作的目的是回顾与烧伤相关的上述临床后遗症的神经回路，并为可能治疗这些疾病的特定NIBS目标提供科学依据。我们进行了系统的审查,在PRISMA声明之后，TDCS对烧伤症状的影响。只有三项研究符合我们的标准。一项是评估烧伤后慢性神经性疼痛的皮质可塑性的可行性研究，一个人研究了tDCS在烧伤伤口护理期间减少疼痛焦虑的效果，一个人评估了tDCS对烧伤幸存者疼痛和瘙痒的治疗效果。目前关于烧伤NIBS的文献仍然有限，只进行了一些试验。根据我们的审查和结果，与烧伤患者症状相似的其他人群，选择了三个主要区域:前额区，顶叶区和运动皮层.基于前额叶皮层在疼痛的情感成分中的重要性及其在各种心理社会症状中的含义，靶向这个区域可能代表最有希望的目标。我们对烧伤后症状中涉及的神经回路进行了回顾，并建议了刺激的目标区域，为未来的研究计划提供了新的思路。
