PDF(Pubmed)
Abstract：
The dorsal anterior cingulate cortex (dACC) is a critical brain area for pain and autonomic processing, making it a promising noninvasive therapeutic target. We leverage the high spatial resolution and deep focal lengths of low-intensity focused ultrasound (LIFU) to noninvasively modulate the dACC for effects on behavioral and cardiac autonomic responses using transient heat pain stimuli. A N = 16 healthy human volunteers (6 M/10 F) received transient contact heat pain during either LIFU to the dACC or Sham stimulation. Continuous electroencephalogram (EEG), electrocardiogram (ECG), and electrodermal response (EDR) were recorded. Outcome measures included pain ratings, heart rate variability, EDR response, blood pressure, and the amplitude of the contact heat-evoked potential (CHEP).LIFU reduced pain ratings by 1.09 ± 0.20 points relative to Sham. LIFU increased heart rate variability indexed by the standard deviation of normal sinus beats (SDNN), low-frequency (LF) power, and the low-frequency/high-frequency (LF/HF) ratio. There were no effects on the blood pressure or EDR. LIFU resulted in a 38.1% reduction in the P2 CHEP amplitude. Results demonstrate LIFU to the dACC reduces pain and alters autonomic responses to acute heat pain stimuli. This has implications for the causal understanding of human pain and autonomic processing in the dACC and potential future therapeutic options for pain relief and modulation of homeostatic signals.
摘要：
背侧前扣带皮质（dACC）是疼痛和自主神经处理的关键大脑区域，使其成为有希望的非侵入性治疗靶标。我们利用低强度聚焦超声（LIFU）的高空间分辨率和深焦距，使用短暂的热痛刺激非侵入性地调节dACC对行为和心脏自主神经反应的影响。N=16名健康人类志愿者(6M/10F)在对dACC或Sham刺激的LIFU期间接受了短暂的接触性热痛。连续脑电图（EEG），心电图(ECG),记录皮肤电反应（EDR）。结果指标包括疼痛评分，心率变异性,EDR响应,血压,和接触热诱发电位（CHEP）的幅度。相对于Sham，LIFU将疼痛评分降低了1.09±0.20分。LIFU通过正常窦性搏动的标准偏差（SDNN）增加了心率变异性，低频（LF）电源，和低频/高频(LF/HF)比。对血压或EDR没有影响。LIFU导致P2CHEP振幅降低38.1%。结果表明，dACC的LIFU减轻了疼痛，并改变了对急性热痛刺激的自主神经反应。这对dACC中人类疼痛和自主神经处理的因果理解以及缓解疼痛和调节稳态信号的潜在未来治疗选择具有意义。重要性声明新的调查线表明，诸如心率变异性（HRV）之类的自主神经信号在慢性疼痛和心理健康障碍中是异常的，这可能有助于他们的潜在病因。背前扣带回皮质（dACC）是疼痛处理的关键中心，直接影响自主神经功能，但它的深度阻碍了没有侵入性手术的直接进入。在人类中第一次，我们证明低强度聚焦超声（LIFU）可以无创和选择性地调节dACC以减少急性疼痛感知，自主反应，和疼痛处理信号。这项工作进一步确立了dACC在疼痛和自主神经处理中的因果作用，并在慢性疼痛和神经心理学人群中具有潜在的未来临床应用。
