Harnessing theta waves: tACS as a breakthrough in alleviating post-stroke chronic pain

 Will your competent? doctor do anything with this?

Here's how long your doctor has been incompetent in not having protocols to prevent this problem. Which means your board of directors is incompetent in not having correct goals for the stroke medical 'professionals'!

39% to 55% post stroke pain (3 posts to October 2022)

The latest here:

Harnessing theta waves: tACS as a breakthrough in alleviating post-stroke chronic pain

Ningjing Song^1,2,3,4Ling Long^1,2,3,4Nianquan Liu^1,2,3,4Yujun Luo^1,2,3,4Meng Wei^1,2,3,4Hai Huang^1,2,3,4*Wan Liu^1,2,3,4*

• ¹Department of Tuina and Rehabilitation Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
• ²Department of Tuina and Rehabilitation Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
• ³Hubei Sizhen Laboratory, Wuhan, China
• ⁴First Clinical Medical College, Hubei University of Chinese Medicine, Wuhan, China

Neural oscillations play a critical role in the regulation of brain functions, with theta waves (4–8 Hz) in the sensorimotor cortex significantly influencing pain perception and modulation. These oscillations can modulate pain signal transmission, emotional cognition, and neuroplasticity. Post-stroke chronic pain is a common and complex symptom that imposes significant physiological and psychological burdens on patients. Transcranial alternating current stimulation (tACS), a non-invasive brain stimulation technique, can synchronize specific frequency neural activities, reorganize brain networks, and modulate neuroplasticity by adjusting specific frequency neural oscillations. In recent years, tACS has been widely applied in the research and treatment of various neurological and psychiatric disorders. This study aims to systematically summarize the current research progress on the regulation of θ oscillations in sensorimotor cortex by tACS. By reviewing relevant experimental and clinical studies, we explore the specific mechanisms of θ oscillations in pain perception and modulation and analyze the mechanisms and effects of tACS modulation of θ oscillations. Additionally, we examine the central and peripheral neural mechanisms of post-stroke chronic pain, emphasizing the critical role of the sensorimotor cortex in pain processing. In conclusion, tACS shows potential for modulating sensorimotor cortex θ oscillations and alleviating post-stroke chronic pain. This research provides new insights into the neural modulation mechanisms related to pain and offers potential new directions for developing novel therapies. Future clinical studies and technological optimizations are necessary to ensure the effectiveness and feasibility of tACS in clinical practice.

1 Introduction

Chronic post-stroke pain (PSCP) is a prevalent complication, affecting approximately 12% of individuals who have experienced a stroke (Zhan et al., 2019). The pathogenesis of PSCP is intricate, involving the reorganization and dysfunction of both the central and peripheral nervous systems (Larson et al., 2019). Patients frequently endure severe neuropathic pain, sensory abnormalities, and heightened pain sensitivity. Current therapeutic interventions, including pharmacological treatments, physiotherapy, and cognitive behavioral therapy, often demonstrate limited efficacy, with many patients struggling to achieve sustained pain relief (Haslam et al., 2021). Central nervous system pathological alterations are central to the challenging nature of PSCP, particularly the dysfunction of the sensorimotor cortex, which is closely linked to pain perception. Consequently, the modulation of sensorimotor cortex activity to alleviate pain has emerged as an urgent research priority. Recent advancements in neuroscience have highlighted the significant role of neural electrical activity in pain stimulation and perception (Yin and Zhao, 2024). Consequently, the modulation of sensorimotor cortex activity to alleviate pain has emerged as an urgent research priority.

Recent advancements in neuroscience have highlighted the significant role of neural electrical activity in pain stimulation and perception, emphasizing the importance of neural oscillation energy regulation and phase properties in the onset and modulation of pain. Neural oscillations are integral not only to pain processing but also to a wide range of cognitive and sensory functions. The sensorimotor cortex, a critical region for processing sensory input and motor output (Kong et al., 2024), is particularly influenced by θ-wave (4–8 Hz) neural oscillations (θ oscillations), which are pivotal in sensorimotor integration, attention regulation, and pain modulation. Research indicates that synchronized θ wave activity may enhance the integration of sensory information and the formulation of motor plans by modulating the functional connectivity within the sensorimotor network. Furthermore, θ waves play a distinctive role in pain modulation, particularly in chronic pain conditions, where abnormalities in θ wave patterns may be linked to central sensitization phenomena. Such abnormalities in neural oscillation patterns are posited to be central mechanisms in the development of chronic pain.

Transcranial alternating current stimulation (tACS) is an emerging neuromodulation technique that non-invasively applies specific frequency alternating currents to the scalp to modulate neural oscillations in the brain (Feurra et al., 2011; Wischnewski et al., 2023). Transcranial alternating current stimulation (tACS) presents a promising avenue for the treatment of persistent sensorimotor cortex pain (PSCP) through the modulation of θ oscillations. Although the application of tACS in pain research remains in its nascent stages, ongoing investigations continue to explore its analgesic effects and underlying mechanisms, with a current paucity of direct evidence to definitively elucidate the analgesic mechanism of tACS (Angelakis et al., 2013; May et al., 2021). This study aims to systematically synthesize the existing research on the modulation of θ oscillations in the sensorimotor cortex via tACS, to investigate the specific role of these oscillations in pain perception and modulation, and to analyze the effects and mechanisms of their modulation by tACS. Furthermore, this paper will delve into the mechanisms of tACS intervention in PSCP, with a particular focus on the central and peripheral neural mechanisms involved, highlighting the critical role of the sensorimotor cortex in pain processing. Additionally, the paper will propose future research directions and discuss the clinical application prospects of tACS, with the objective of providing a theoretical foundation and practical references for the treatment of chronic pain using this modality.

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