The effects of transcranial direct current stimulation with visual illusion in neuropathic pain due to spinal cord injury: An evoked potentials and quantitative thermal testing study

Abstract

Two weeks of tDCS + VI induced significant changes in CHEPs, evoked pain and heat pain threshold in SCI patients with NP. These neurophysiological tests might be objective biomarkers of treatment effects for NP in patients with SCI.

Delayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial

“…In a previous study, our group has tested the effects of tDCS in SCI patients suffering from neuropathic pain, showing that 5 sessions of M1 tDCS significantly reduced level of pain after the end of the stimulation sessions but not when reassessed at 2-week follow-up [7]. Other studies, investigating the neural correlates of tDCS in SCI, or the combination of tDCS with adjuvant therapy, have found similar results on pain intensity reduction following the stimulation of M1 [17][18][19][20].…”

“…The authors explained that lack of effects is likely due to refractoriness of pain and duration of disease since most of the patients enrolled had injury durations of 10 or more years. In addition, the limited number of [19][20][21][22][23][24][25][26] sessions and small sample size, may not have been sufficient to observe significant effects at follow-up. The second study, on low back pain, even though the sample size was large (n = 135), did not show significant differences between sham and active tDCS [58].…”

“…This observation highlights the long-term effects of tDCS in maintaining low level of pain as compared to the sham intervention. As abovementioned, several studies have highlighted the need for repeating the number of tDCS sessions (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) to induce long-lasting and clinically relevant effects. In the present study, even with a limited sample size, we demonstrated that adding a second phase of 10 stimulations sessions can help maintaining the benefits induced by tDCS.…”

Virtual feedback for motor and pain rehabilitation after spinal cord injury

“…VF interventions and assessments were focused on improving motor functions in patients that were pain-free (or in whom pain was not reported; n = 12) 1,2,12-21 or on reducing pain in patients with different levels of motor dysfunction and neuropathic pain (n = 4). 4,5,22,23 Only one study explicitly assessed the effects of a VF intervention on both motor dysfunctions and neuropathic pain. 6 VF modalities and tasks Improving motor functions.…”

“…VF uses virtual reality displayed on large screens or on head-mounted displays to provide patients with interactive, multimodal sensory stimuli and biofeedback, and may be applied alone or in combination with physical or cognitive interventions. For example, 'virtual walking', offering an illusion of normal gait, may improve motor functions 1,2 and may reduce neuropathic pain [3][4][5] after spinal cord injury (SCI).…”