Neues zur Hirnstimulation bei chronischen Schmerzen

Zusammenfassung

Chronischer Schmerz hat seine Warnfunktion verloren und ist mit einer Dysfunktion des sog. Schmerznetzwerks assoziiert. Eine ggf. konsekutive Applikation der Hirnstimulation zielt durch die Modulation neuronaler Aktivitäten auf eine Normalisierung dieses Netzwerkes ab. Die nicht invasive Gleichstromstimulation (tDCS) oder repetitive transkranielle Magnetstimulation (rTMS) gelten in der Schmerzbehandlung als wirksam. Hierbei spielt die Stimulation des primären motorischen Kortex (M1) eine zentrale Rolle. Bei nicht ausreichender positiver Beeinflussung des Schmerzes durch tDCS und rTMS stehen invasive Verfahren wie Motorkortexstimulation (MCS) oder tiefe Hirnstimulation als Ultima Ratio zur Verfügung.

Abstract

Pain that has become chronic has lost its warning function and is associated with a dysfunction of the so-called pain network. Systematic brain stimulation aims to normalize this network by modulating neuronal activities. Non-invasive DC stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) are considered effective in pain treatment. Here, the stimulation of the primary motor cortex (M1) plays a central role. If the pain is not adequately controlled by tDCS and rTMS, in the last instance, invasive procedures such as motor cortex stimulation (MCS) or deep brain stimulation are available.

Schlüsselwörter

tDCS - chronische Schmerzen - Gleichstromstimulation - tiefe Hirnstimulation - Neuromodulation

Keywords

tDCS - chronic pain - transcranial direct current - deep brain stimulation - neuromodulation

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