摘要
经颅聚焦超声(tFUS)是一种新兴的非侵入性神经调控技术,其利用高度聚焦的声波实现对特定脑区的精确、可逆和非侵入性调控,具有高空间分辨率、深部穿透能力和可调节性等特点,在疼痛管理领域展现出巨大潜力。本共识主要从tFUS的技术原理与临床优势、在感觉处理中的神经调控作用、在病理性疼痛条件下的转化应用、安全性和不良反应管理、治疗的规范化操作流程和未来发展方向进行阐述,希望为tFUS未来研究和临床应用提供指导。①tFUS的技术原理与临床优势:主要介绍了tFUS基本工作原理、关键参数、生物物理效应和临床优势。②tFUS在感觉处理中的神经调控作用:主要介绍了精确调控关键脑区、多层次的神经调控机制、对感觉功能的影响。③tFUS在病理性疼痛条件下的转化应用:主要包括慢性神经病理性疼痛、急性疼痛和实验性疼痛模型及偏头痛。④tFUS的安全性和不良反应管理:包括总体安全性评估、常见不良反应及其管理、严重不良事件的应对、长期安全性考虑和特殊人群安全性。⑤tFUS治疗的规范化操作流程:包括适应证和禁忌证评估、治疗前评估、参数选择和优化、治疗过程中的监测和随访管理。⑥未来发展方向:包括优化治疗方案、提高临床可及性、扩大适应证范围、长期疗效和安全性评估。目前tFUS在疼痛管理中的临床研究相对有限,本共识基于现有文献和专家经验,以提供应用参考和未来研究方向。尽管面临挑战,tFUS有望成为慢性疼痛管理的重要补充手段,为难治性疼痛患者提供新的治疗选择。但是,从当前的初步研究结果到广泛临床应用之间还有很长的路要走。只有通过严谨的科学研究和临床验证,tFUS才能真正在未来的精准疼痛医学中发挥重要作用。
Transcranial focused ultrasound(tFUS)is an emerging non-invasive neuromodulation technique,and employs highly focused acoustic waves for precise,reversible,and non-invasive modulation of specific brain regions.Characterized by high spatial resolution,deep penetration,and adjustability,tFUS shows great potential in the field of pain management.This consensus statement provides a comprehensive overview of the technical principles and clinical benefits of tFUS,the neuromodulatory effects of tFUs in sensory processing,its translational applications in pathological pain conditions,safety and management of adverse events,standardized operational procedures,and future research directions,with the aim of guiding future studies and clinical applications of tFUS.(1)Technical principles and clinical advantages of tFUS,including its fundamental working mechanisms,critical parameters,biophysical effects,and clinical benefits.(2)Neuromodulatory effects of tFUS in sensory processing,emphasizing the precise modulation of key brain areas,multi-tiered neural regulatory mechanisms,effects on sensory functions.(3)Translational applications in pathological pain conditions,encompassing chronic neuropathic pain,acute pain,experimental pain models and migraine.(4)Safety and adverse event management,including comprehensive safety evaluations,common adverse reactions and their management strategies,responses to serious adverse events,long-term safety considerations,and safety in specific populations.(5)Standardized operational procedures for tFUS treatment,encompassing assessment of indications and contraindications,pre-treatment evaluations,parameter selection and optimization,monitoring during treatment,and post-treatment follow-up management.(6)Future directions,including optimization of treatment protocols,enhancement of clinical accessibility,broadening of indication scopes,and assessments of long-term efficacy and safety.Currently,clinical research on tFUS in pain management is relatively limited.This consensus statement is grounded in existing literature and expert insights to offer guidance for applications and future research directions.Despite the challenges,tFUS holds promise as a significant complementary approach in chronic pain management,providing new therapeutic options for patients with refractory pain.However,there is still a significant gap between current preliminary research findings and their broad clinical application.Only through rigorous scientific research and clinical validation tFUS can play a pivotal role in the future of precise pain medicine.
出处
《康复学报》
2025年第4期351-362,共12页
Rehabilitation Medicine
关键词
慢性疼痛
经颅聚焦超声
神经调控
精准医学
专家共识
chronic pain
transcranial focused ultrasound
neuromodulation
precision medicine
expert consensus
