Efficacy of Home-Based Transcranial Direct Current Stimulation Over the Primary Motor Cortex and Dorsolateral Prefrontal Cortex in the Disability Due to Pain in Fibromyalgia: A Factorial Sham-Randomized Clinical Study

Caumo, Wolnei; Lopes Ramos, Rael; Vicuña Serrano, Paul; da Silveira Alves, Camila Fernanda; Medeiros, Liciane; Ramalho, Leticia; Tomeddi, Rafalea; Bruck, Samara; Boher, Lucas; Sanches, Paulo R.S.; Silva, Danton P.; LS Torres, Iraci; Fregni, Felipe

doi:10.1016/j.jpain.2023.09.001

Cited by 5 publications

(7 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accordingly, anodal M1 tDCS can be categorized as "effective" in reducing pain in patients with FM [8]. The findings from recent robust RCT studies, including those by Caumo et al (2023) [41] and Samartin-Veiga et al (2022) [39], also indicate a "probably effective" use of DLPFC tDCS in pain reduction in patients with FM. This emerging evidence underscores the necessity of revisiting and potentially updating the guidelines for tDCS application to FM to incorporate these new insights for more effective clinical application.…”

Section: Efficacymentioning

confidence: 98%

“…12 studies were excluded with reasons (Figure 1) for using combined intervention with tDCS (n = 5) [20][21][22][23][24], not being an RCT (n = 4), crossover design (n = 2) [25,26], and one protocol study (n = 1) [27]. 14 studies were thus included in the final analysis [28][29][30][31][32][33][34][35][36][37][38][39][40][41].…”

Section: Study Inclusionmentioning

confidence: 99%

“…Of the 14 included studies, four RCTs examined the effects of tDCS over the primary motor cortex and DLPFC in different groups of patients [28,29,39,41], which allows us to compare the efficacy of each protocol. In all of the studies, stimulation intensity was 2 mA, and stimulation polarity was anodal.…”

Section: Tdcs Over M1 Vs Dlpfcmentioning

confidence: 99%

“…This study found significant treatment effects across time for clinical pain and for fatigue, cognitive and sleep disturbances, and experimental pain, irrespective of the group, which provides evidence of a placebo effect. The only outcome measure that was specific to tDCS was mood, which was significantly improved in both M1 tDCS and DLPFC tDCS groups [41]. The most recently published RCT also compared the efficacy of M1 vs. DLPFC tDCS on the pain and fatigue states of patients with FM after 20 sessions of stimulation.…”

Section: Tdcs Over M1 Vs Dlpfcmentioning

confidence: 99%

“…One important aspect of the included studies was the use of home-based tDCS for clinical use in patients with pain, which was investigated in three studies during and after the COVID-19 pandemic [36,38,41]. While in two studies only DLPFC tDCS was applied [36,38], in one study both M1 tDCS and DLPFC tDCS were compared.…”

Section: Home-based Tdcsmentioning

confidence: 99%

See 4 more Smart Citations

Efficacy of Transcranial Direct Current Stimulation on Pain Level and Disability of Patients with Fibromyalgia: A Systematic Review of Randomized Controlled Trials with Parallel-Group Design

Azarkolah,

Noorbala,

Ansari

et al. 2023

Brain Sciences

View full text Add to dashboard Cite

Transcranial direct current stimulation (tDCS) has been increasingly applied in fibromyalgia (FM) to reduce pain and fatigue. While results are promising, observed effects are variable, and there are questions about optimal stimulation parameters such as target region (e.g., motor vs. prefrontal cortices). This systematic review aimed to provide the latest update on published randomized controlled trials with a parallel-group design to examine the specific effects of active tDCS in reducing pain and disability in FM patients. Using the PRISMA approach, a literature search identified 14 randomized controlled trials investigating the effects of tDCS on pain and fatigue in patients with FM. Assessment of biases shows an overall low-to-moderate risk of bias. tDCS was found effective in all included studies conducted in patients with FM, except one study, in which the improving effects of tDCS were due to placebo. We recommended tDCS over the motor and prefrontal cortices as “effective” and “probably effective” respectively, and also safe for reducing pain perception and fatigue in patients with FM, according to evidence-based guidelines. Stimulation polarity was anodal in all studies, and one single-session study also examined cathodal polarity. The stimulation intensity ranged from 1-mA (7.14% of studies) to 1.5-mA (7.14% of studies) and 2-mA (85.7% of studies). In all of the included studies, a significant improvement in at least one outcome variable (pain or fatigue reduction) was observed. Moreover, 92.8% (13 of 14) applied multi-session tDCS protocols in FM treatment and reported significant improvement in their outcome variables. While tDCS is therapeutically effective for FM, titration studies that systematically evaluate different stimulation intensities, durations, and electrode placement are needed.

show abstract

Section: Efficacymentioning

confidence: 98%

Section: Study Inclusionmentioning

confidence: 99%

Section: Tdcs Over M1 Vs Dlpfcmentioning

confidence: 99%

Section: Tdcs Over M1 Vs Dlpfcmentioning

confidence: 99%

Section: Home-based Tdcsmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy of Transcranial Direct Current Stimulation on Pain Level and Disability of Patients with Fibromyalgia: A Systematic Review of Randomized Controlled Trials with Parallel-Group Design

Azarkolah,

Noorbala,

Ansari

et al. 2023

Brain Sciences

View full text Add to dashboard Cite

show abstract

Independent effects of transcranial direct current stimulation and social influence on pain

Dehghani,

Bango,

Murphy

et al. 2024

Pain

View full text Add to dashboard Cite

Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulatory technique with the potential to provide pain relief. However, tDCS effects on pain are variable across existing studies, possibly related to differences in stimulation protocols and expectancy effects. We investigated the independent and joint effects of contralateral motor cortex tDCS (anodal vs cathodal) and socially induced expectations (analgesia vs hyperalgesia) about tDCS on thermal pain. We employed a double-blind, randomized 2 × 2 factorial cross-over design, with 5 sessions per participant on separate days. After calibration in Session 1, Sessions 2 to 5 crossed anodal or cathodal tDCS (20 minutes 2 mA) with socially induced analgesic or hyperalgesic expectations, with 6 to 7 days between the sessions. The social manipulation involved videos of previous “participants” (confederates) describing tDCS as inducing a low-pain state (“analgesic expectancy”) or hypersensitivity to sensation (“hyperalgesic expectancy”). Anodal tDCS reduced pain compared with cathodal stimulation (F(1,19.9) = 19.53, P < 0.001, Cohen d = 0.86) and analgesic expectancy reduced pain compared with hyperalgesic expectancy (F(1,19.8) = 5.62, P = 0.027, Cohen d = 0.56). There was no significant interaction between tDCS and social expectations. Effects of social suggestions were related to expectations, whereas tDCS effects were unrelated to expectancies. The observed additive effects provide novel evidence that tDCS and socially induced expectations operate through independent processes. They extend clinical tDCS studies by showing tDCS effects on controlled nociceptive pain independent of expectancy effects. In addition, they show that social suggestions about neurostimulation effects can elicit potent placebo effects.

show abstract

Combining Transcranial Direct Current Stimulation With Non-Invasive Interventions for Chronic Primary Pain: A Systematic Review and Meta-Analysis

Lyra de Brito Aranha,

Nascimento,

Sampaio

et al. 2024

Neurorehabil Neural Repair

View full text Add to dashboard Cite

Background A growing number of studies has combined transcranial direct current stimulation (tDCS) with other non-invasive non-pharmacological therapies (NINPT) to enhance effects in pain reduction. However, the efficacy of these combined approaches in treating chronic primary pain (CPP) warrants thorough investigation. Objective This study aims to evaluate the efficacy of tDCS in conjunction with other NINPT in alleviating pain severity among CPP patients. Methods We conducted a systematic search for randomized controlled trials (RCTs) comparing the efficacy of tDCS combined with NINPT against control treatments in adult CPP patients. The search spanned multiple databases, including PubMed, EMBASE, LILACS, Scopus, Web of Science, and CENTRAL. Results Our systematic review included 11 RCTs with a total of 449 participants. In our meta-analysis, which comprised 228 participants receiving active-tDCS and 221 receiving sham-tDCS, we found a significant reduction in pain intensity (Standard Mean Difference = −0.73; 95% Confidence Interval (CI) = −1.18 to −0.27; P = .002) with the use of active-tDCS combined with NINPT. Conclusion These findings substantiate the therapeutic potential of combining tDCS with other NINPT, highlighting it as an effective treatment modality for reducing pain intensity in CPP patients.

show abstract

Efficacy of Home-Based Transcranial Direct Current Stimulation Over the Primary Motor Cortex and Dorsolateral Prefrontal Cortex in the Disability Due to Pain in Fibromyalgia: A Factorial Sham-Randomized Clinical Study

Cited by 5 publications

References 66 publications

Efficacy of Transcranial Direct Current Stimulation on Pain Level and Disability of Patients with Fibromyalgia: A Systematic Review of Randomized Controlled Trials with Parallel-Group Design

Efficacy of Transcranial Direct Current Stimulation on Pain Level and Disability of Patients with Fibromyalgia: A Systematic Review of Randomized Controlled Trials with Parallel-Group Design

Independent effects of transcranial direct current stimulation and social influence on pain

Combining Transcranial Direct Current Stimulation With Non-Invasive Interventions for Chronic Primary Pain: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About