The Effect of Transcranial Direct Current Stimulation on Chronic Neuropathic Pain in Patients with Multiple Sclerosis: Randomized Controlled Trial

Abstract

Objective Chronic neuropathic pain is a common symptom in multiple sclerosis (MS). This randomized controlled single-blinded study investigated whether a new protocol involving five days of transcranial direct current stimulation (tDCS) with an interval period would be effective to reduce pain using the visual analog scale (VAS). Other secondary outcomes included the Neuropathic Pain Scale (NPS), Depression Anxiety Stress Score (DASS), Short Form McGill Pain Questionnaire (SFMPQ), and Multiple Sclerosis Quality of Life 54 (MSQOL54). Design A total of 30 participants were recruited for the study, with 15 participants randomized to a sham group or and 15 randomized to an active group. After a five-day course of a-tDCS, VAS and NPS scores were measured daily and then weekly after treatment up to four weeks after treatment. Secondary outcomes were measured pretreatment and then weekly up to four weeks. Results After a five-day course of a-tDCS, VAS scores were significantly reduced compared with sham tDCS and remained significantly low up to week 2 post-treatment. There were no statistically significant mean changes in MSQOL54, SFMPQ, NPS, or DASS for the sham or treatment group before treatment or at four-week follow-up. Conclusions This study shows that repeated stimulation with a-tDCS for five days can reduce pain intensity for a prolonged period in patients with MS who have chronic neuropathic pain.

Non-invasive Brain Stimulation for Central Neuropathic Pain

“…The analgesic mechanisms of rTMS and tDCS are similar, which both alter cortical excitability and synaptic plasticity, regulate the release of related neurotransmitters, and affect the structural and functional connections of brain regions associated with pain processing and regulation ( Figure 4 ; Zheng et al, 2011 ; Thibaut et al, 2017 ; Hassan et al, 2021 ; Molero-Chamizo et al, 2021 ). tDCS has been studied in several studies and was able to manage pain effectively, but its optimal stimulation targets, stimulation intensity, and stimulation time for each type of CNP are still difficult to identify ( Iodice et al, 2017 ; Wen et al, 2017 ; Young et al, 2020 ). NIBS not only affects the cerebral cortex at the stimulated site but also affects the related functional areas of the brain based on the pain matrix.…”

Relieving Chronic Musculoskeletal Pain in Older Adults Using Transcranial Direct Current Stimulation: Effects on Pain Intensity, Quality, and Pain-Related Outcomes

“…A second limitation is that the short follow-up period does not provide data to draw conclusions regarding the long-term efficacy of tDCS. Some studies conducted on younger populations showed that 5 sessions of tDCS can produce a significant hypoalgesic effect that can last up to 6 months after the end of stimulations ( 83 – 85 ). In older adults, the longest follow-up period for 5 tDCS sessions demonstrated that knee OA pain can be reduced up to 3 weeks after the last tDCS intervention ( 74 ).…”

Механізми Виникнення Та Хронізації Нейропатичного Болю При Розсіяному Склерозі В Клінічних Та Експериментальних Умовах

“…Хімічна та/або електрична стимуляція, а також гальмування мозку та підшкірної клітковини використовували для лікування різних хронічних больових станів [47]. Транс краніальна стимуляція [48], стимуляція поля перифе ричних нервів, черезшкірна спінальна стимуляція [49] також на лежать до методів лікування НБ при РС.…”