Self-administered transcranial direct current stimulation for pain in older adults with knee osteoarthritis: A randomized controlled study

Martorella, Géraldine; Mathis, Kenneth B.; Miao, Hongyu; Wang, Duo; Park, Lindsey; Ahn, Hyochol

doi:10.1016/j.brs.2022.06.003

Cited by 14 publications

(44 citation statements)

References 41 publications

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“…In total, 120 participants were successfully recruited and randomly assigned to the active tDCS group (60 subjects) or the sham tDCS group (60 subjects), and the sample included approximately 68% women. CONSORT flow diagram as provided in Martorella et al (2022) [ 7 ]. See Table 1 in Martorella et al (2022) [ 7 ] for the baseline demographics and clinical characteristics of all participants in this study.…”

Section: Resultsmentioning

confidence: 99%

“…Our detailed protocol and enrollment procedures are described in a previous article reporting the primary outcomes of our study [ 7 ]. Summarily, after signing a consent form, 120 individuals were randomly assigned to two groups (i.e., 60 participants in each group).…”

Section: Methodsmentioning

confidence: 99%

“…Clinical pain measures are described in detail in our previous article [ 7 ]. Briefly, clinical pain intensity (i.e., knee pain) over the past 24 h was assessed using a Numeric Rating Scale (NRS), with anchors being 0 (no pain) to 100 (worst pain imaginable) [ 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…Building on these initial findings, examining the efficacy of home-based tDCS on clinical pain intensity, experimental pain sensitivity, and their relationship in a large-scale controlled trial may strengthen our understanding in uncovering the underlying mechanism of action. In the primary study focused on clinical pain [ 7 ], we observed a significant reduction of pain intensity (Cohen′s d 1.20; p -value < 0.0001), while participants expressed a high level of satisfaction and no adverse events.…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, experimental pain sensitivity defined as “the result of complex processes at different sites of the pathways that are involved in the generation, transmission, elaboration and perception of pain” [ 6 ] in response to a standardized and controlled stimulus can help illuminate nociceptive processes and understand individual variability as to why a stimulus is perceived as more or less painful. Our work with individuals suffering from knee OA has previously shown that both clinic-based and home-based tDCS can lead to a reduction in clinical pain intensity [ 7 , 8 ]. However, although individuals with OA pain have demonstrated higher levels of experimental pain sensitivity [ 5 , 9 ], few studies have evaluated the impact of tDCS on experimental pain sensitivity, which might prevent from clarifying underlying therapeutic mechanisms.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Home-Based Transcranial Direct Current Stimulation on Experimental Pain Sensitivity in Older Adults with Knee Osteoarthritis: A Randomized, Sham-Controlled Clinical Trial

Martorella

Mathis

Miao

et al. 2022

JCM

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Although transcranial direct current stimulation (tDCS) is encouraging regarding clinical pain intensity for individuals with knee osteoarthritis, very few studies have explored its impact on experimental pain sensitivity, which may hinder our understanding of underlying therapeutic mechanisms. The purpose of this study was to assess the efficacy of 15 home-based tDCS sessions on experimental pain sensitivity and explore its relationships with clinical pain intensity. We randomly assigned 120 participants to active tDCS (n = 60) and sham tDCS (n = 60). Quantitative sensory testing (QST) was used, including heat pain threshold and tolerance, pressure pain threshold, and conditioned pain modulation. Patients in the active tDCS group exhibited reduced experimental pain sensitivity as reflected by all QST measures at the end of treatment. Furthermore, correlations were observed between changes in clinical pain intensity and experimental pain sensitivity. These findings warrant further studies on tDCS and experimental pain sensitivity in patients with knee osteoarthritis and exploring the magnitude and sustainability of effects on a longer term.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of Home-Based Transcranial Direct Current Stimulation on Experimental Pain Sensitivity in Older Adults with Knee Osteoarthritis: A Randomized, Sham-Controlled Clinical Trial

Martorella

Mathis

Miao

et al. 2022

JCM

Self Cite

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Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Yang,

Li,

Wang

et al. 2024

Arthritis Care & Research

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BackgroundThe effects of transcranial direct current stimulation (tDCS) in the treatment of knee osteoarthritis (KOA) is still unclear.ObjectiveTo evaluate the efficacy and safety of tDCS in improving symptoms in patients with KOA.Data sources and study selectionThe following electronic databases were searched for eligible randomized controlled trials (RCTs): PubMed, EMBASE, Web of Science, and the Cochrane Library. The search was performed from the inception dates to April 30, 2023.Data extraction and synthesisData extraction and quality assessment were performed by 2 independent reviewers. Standard mean differences (SMDs) with 95% confidence intervals (95% CIs) for pooled data were calculated. A random‐effects model was used for the data analyses.Main outcomes and measuresThe primary outcomes were pain and physical function. Secondary outcomes included stiffness, mobility performance, quality of life, pressure pain tolerance, and plasma levels of brain‐derived neurotrophic factor (BDNF).ResultsThis meta‐analysis included 13 RCTs. tDCS was significantly associated with pain decrease compared with sham tDCS (SMD = ‐0.62, 95% CI: [‐0.87, ‐0.37], P < 0.00001). When compared tDCS plus other non‐tDCS with sham tDCS plus other non‐tDCS, there was no longer an significant association with pain decrease (SMD = ‐0.45, 95% CI: [‐1.08, 0.17], P = 0.16). The changes in physical function were not significantly different between the tDCS and sham tDCS groups. (SMD = ‐0.09, 95% CI: [‐0.56, 0.38], P = 0.71). When compared tDCS plus other non‐tDCS with sham tDCS plus other non‐tDCS, there was still no significant association with improvement in physical function (SMD = ‐0.66, 95% CI: [‐1.63, 0.30], P = 0.18). There was no significant difference with improvement in stiffness (SMD = ‐0.21, 95% CI: [‐0.77, 0.34], P = 0.45), mobility performance (SMD = 4.58, 95% CI: [‐9.21, 18.37], P = 0.51), quality of life (SMD = ‐7.01, 95% CI: [‐22.61, 8.59], P = 0.38), pressure pain tolerance (SMD = 0.30, 95% CI: [‐0.09, 0.69], P = 0.13). There was a statistically significant reduction in plasma levels of BDNF (SMD = ‐13.57, 95% CI: [‐24.23, ‐2.92], P = 0.01)ConclusionsIn conclusion, tDCS could significantly alleviate pain, but it might had no efficacy in physical function, stiffness, mobility performance, quality of life, pressure pain tolerance among KOA patients.

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Letter to the editor regarding: “Self-administered transcranial direct current stimulation for pain in older adults with knee osteoarthritis: A randomized controlled study”

Silva-Filho

Pegado

2023

Brain Stimulation

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Self-administered transcranial direct current stimulation for pain in older adults with knee osteoarthritis: A randomized controlled study

Cited by 14 publications

References 41 publications

Efficacy of Home-Based Transcranial Direct Current Stimulation on Experimental Pain Sensitivity in Older Adults with Knee Osteoarthritis: A Randomized, Sham-Controlled Clinical Trial

Efficacy of Home-Based Transcranial Direct Current Stimulation on Experimental Pain Sensitivity in Older Adults with Knee Osteoarthritis: A Randomized, Sham-Controlled Clinical Trial

Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Letter to the editor regarding: “Self-administered transcranial direct current stimulation for pain in older adults with knee osteoarthritis: A randomized controlled study”

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