Combined transcranial direct current stimulation and breathing-controlled electrical stimulation for management of neuropathic pain  after spinal cord injury

Li, Shengai; Stampas, Argyrios; Frontera, Joel; Davis, Matthew

doi:10.2340/16501977-2379

Cited by 13 publications

(9 citation statements)

References 46 publications

(79 reference statements)

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“…Over the last years, clinical studies targeting anodal M1 for pain control have had significant results. Different conditions have been considered as fibromyalgia [17,[48][49][50][51][52][53][54][55][56][57], neuropathic pain [58][59][60][61][62][63][64][65][66][67][68][69][70], migraine [71][72][73][74][75][76], low back pain (LBP) [77][78][79][80][81], musculoskeletal conditions [16,[82][83][84][85][86][87], myofascial pain syndrome [88,89], post-operative pain [90][91][92][93], among others (See Table 1).…”

Section: Primary Motor Cortex (M1) Tdcsmentioning

confidence: 99%

Methods and strategies of tDCS for the treatment of pain: current status and future directions

Pacheco‐Barrios¹,

Cardenas-Rojas

Thibaut

et al. 2020

Expert Review of Medical Devices

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Introduction: Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation technique which has been widely studied for the treatment of chronic pain. It is considered a promising and safe alternative pain therapy. Different targets have been tested, each having their own particular mechanisms for modulating pain perception. Areas covered:We discuss the current state of the art of tDCS to manage pain and future strategies to optimize tDCS' effects. Current strategies include primary motor cortex tDCS, prefrontal tDCS and tDCS combined with behavioral interventions while future strategies, on the other hand, include high intensity tDCS, transcutaneous Spinal Direct Current Stimulation, cerebellar tDCS, home-based tDCS and tDCS with extended number of sessions.Expert commentary: It has been shown that the stimulation of the prefrontal and primary motor cortex is efficient for pain reduction while a few other new strategies, such as high intensity tDCS and network-based tDCS, are believed to induce strong neuroplastic effects, although the underlying neural mechanisms still need to be fully uncovered. Hence, conventional tDCS approaches demonstrated promising effects to manage pain and new strategies are under development to enhance tDCS effects and make this approach more easily available by using, for instance, home-based devices.

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Section: Primary Motor Cortex (M1) Tdcsmentioning

confidence: 99%

Methods and strategies of tDCS for the treatment of pain: current status and future directions

Pacheco‐Barrios¹,

Cardenas-Rojas

Thibaut

et al. 2020

Expert Review of Medical Devices

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show abstract

“…It is a safe and non-invasive therapeutic method that changes cortex excitability according to the stimulation polarity, producing long-lasting effects (9). In addition, previous studies suggested the use of tDCS as an approach to enhance or "boost" physical therapy (10,11). A commonly used form of rehabilitation is mirror therapy (MT), which involves a mirror being placed in a position that allows the patient to view a reflection of a body part (12).…”

Section: Introductionmentioning

confidence: 99%

Transcranial Direct Current Stimulation and Mirror Therapy for Neuropathic Pain After Brachial Plexus Avulsion: A Randomized, Double-Blind, Controlled Pilot Study

et al. 2020

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Introduction: Although transcranial direct current stimulation (tDCS) and mirror therapy (MT) have benefits in combating chronic pain, there is still no evidence of the effects of the simultaneous application of these techniques in patients with neuropathic pain. This study aims to assess the efficacy of tDCS paired with MT in neuropathic pain after brachial plexus injury.Methods: In a sham controlled, double-blind, parallel-group design, 16 patients were randomized to receive active or sham tDCS administered during mirror therapy. Each patient received 12 treatment sessions, 30 min each, during a period of 4 weeks over M1 contralateral to the side of the injury. Outcome variables were evaluated at baseline and post-treatment using the McGill questionnaire, Brief Pain Inventory, and Medical Outcomes Study 36–Item Short-Form Health Survey. Long-term effects of treatment were evaluated at a 3-month follow-up.Results: An improvement in pain relief and quality of life were observed in both groups (p ≤ 0.05). However, active tDCS and mirror therapy resulted in greater improvements after the endpoint (p ≤ 0.02). No statistically significant differences in the outcome measures were identified among the groups at follow-up (p ≥ 0.12). A significant relationship was found between baseline pain intensity and outcome measures (p ≤ 0.04). Moreover, the results showed that state anxiety is closely linked to post-treatment pain relief (p ≤ 0.05).Conclusion: Active tDCS combined with mirror therapy has a short-term effect of pain relief, however, levels of pain and anxiety at the baseline should be considered.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT04385030.

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“…We read with interest the article by Li et al on the use of combined transcranial direct current stimulation (tDCS) and breathing-controlled electrical stimulation (Bre-Estim) for management of neuropathic pain after spinal cord injury (1,2).…”

Section: Commentary On: "Combined Transcranial Direct Current Stimulamentioning

confidence: 99%

“…The authors did not specify the time interval between interventions, and why the pain level was assessed after 10 mins. In order to check the immediate effect the pain level should have been assessed immediately after the intervention (1).…”

Section: Commentary On: "Combined Transcranial Direct Current Stimulamentioning

confidence: 99%

“…The methodology states that the total number of electrical stimuli given during the BreEstim intervention was 160, with sufficient rest during treatment and a duration of approximately 20 min. It is not clear why the term "approximately" was used for treatment duration; the duration of treatment should be specific (1).…”

Section: Commentary On: "Combined Transcranial Direct Current Stimulamentioning

confidence: 99%

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Commentry on: Combined transcranial direct current stimulation and breathing controlled electrical stimulation for the management of neuropathic pain after spinal cord injury

Srivastav¹,

Sharma²,

Khadayat³

2019

J Rehabil Med

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Combined transcranial direct current stimulation and breathing-controlled electrical stimulation for management of neuropathic pain after spinal cord injury

Abstract: The immediate analgesic effect of breathing-controlled electrical stimulation was confirmed. However, this effect was not augmented after one session of transcranial direct current stimulation treatment.

Cited by 13 publications

References 46 publications

Methods and strategies of tDCS for the treatment of pain: current status and future directions

Methods and strategies of tDCS for the treatment of pain: current status and future directions

Transcranial Direct Current Stimulation and Mirror Therapy for Neuropathic Pain After Brachial Plexus Avulsion: A Randomized, Double-Blind, Controlled Pilot Study

Commentry on: Combined transcranial direct current stimulation and breathing controlled electrical stimulation for the management of neuropathic pain after spinal cord injury

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