DLPFC-rTMS镇痛的神经可塑性机制：TMS-EEG研究

The dorsolateral prefrontal cortex (DLPFC) is an important target for repeated transcranial magnetic stimulation (rTMS) in alleviating pain. However, the analgesic effect of DLPFC-rTMS needs to be optimized and its mechanism of action remains unclear. Simultaneous transcranial magnetic stimulation and electroencephalography (TMS-EEG) can evaluate neuroplastic changes beyond the motor cortex. In this study, we used TMS-EEG technology to investigate local and distributed neuroplastic changes associated with DLPFC analgesia. Thirty-four healthy adults underwent randomized, crossover design of DLPFC or sham stimulation. At each stage, participants underwent cold pain and TMS-EEG evaluations before and after 10Hz transcranial magnetic stimulation. We provide new findings that DLPFC analgesia is associated with smaller N120 amplitude in the contralateral prefrontal cortex and larger N120 peak in the ipsilateral insular cortex. Furthermore, there is a strong negative correlation between the N120 changes in these two regions, and the amplitude changes of both regions are correlated with an increase in pain threshold. In addition, DLPFC stimulation enhances coherence between the prefrontal cortex and somatosensory cortex in the gamma frequency range. Overall, our data provide new evidence for local and distributed neuroplastic changes associated with DLPFC analgesia.