Transcranial DC Stimulation Coupled With TENS for the Treatment of Chronic Pain

Boggio, Paulo S.; Amâncio, Edson José; Correa, Carlos; Cecilio, Sofia Barros; Valasek, Cláudia Aparecida; Bajwa, Zahid H.; Freedman, Steven D.; Pascual‐Leone, Álvaro; Edwards, Dylan; Fregni, Felipe

doi:10.1097/ajp.0b013e3181af1414

Cited by 109 publications

(123 citation statements)

References 21 publications

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“…Nonetheless, most research on tDCS thus far has been concerned with changing the excitability of the cerebral cortex, thereby affecting and adjusting movement, sensation, cognition, and exercise rehabilitation (Webster et al 2006;Antal et al 2007). Some reports describe the application of tDCS for pain resulting from a peripheral lesion (Boggio et al 2009) or central pain due to spinal cord injury (Fregni et al 2006a). However, research on CPSP is lacking.…”

Section: Introductionmentioning

confidence: 99%

Analgesic Effect of Transcranial Direct Current Stimulation on Central Post-Stroke Pain

Bae

Kim

2014

Tohoku J. Exp. Med.

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Pain that occurs after a stroke lowers the quality of life. Such post-stroke pain is caused in part by the brain lesion itself, called central post-stroke pain. We investigated the analgesic effects of transcranial direct current stimulation (tDCS) in stroke patients through quantitative sensory testing. Fourteen participants with central post-stroke pain (7 female and 7 male subjects) were recruited and were allocated to either tDCS (n = 7) or sham-tDCS (n = 7) group. Their ages ranged from 45 to 55 years. tDCS was administered for 20 min at a 2-mA current intensity, with anodal stimulations were performed at primary motor cortex. The sham-tDCS group was stimulated 30-second current carrying time. Both group interventions were given for 3 days per week, for a period of 3 weeks. Subjective pain was measured using the visual analogue scale (VAS) of 0 to 10. Sensations of cold and warmth, and pain from cold and heat were quantified to examine analgesic effects. The sham-tDCS group showed no statistically significant differences in time. In contrast, tDCS group showed decreased VAS scores and skin temperature (p < 0.05). The threshold temperatures for the sense of cold and pain from cold increased (p < 0.05), and those for the sense of warmth and pain from heat decreased (p < 0.05). Our findings indicate that tDCS improved sensory identification and exerted analgesic effects in the stroke patients with central post-stroke pain.

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Section: Introductionmentioning

confidence: 99%

Analgesic Effect of Transcranial Direct Current Stimulation on Central Post-Stroke Pain

Bae

Kim

2014

Tohoku J. Exp. Med.

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“…The pathogenesis may be related to non-specific systemic reactions which are stimulated by various factors, in particular, severe, persistent and unmanageable stimuli can lead to obvious symptoms of disease (20).…”

Section: Discussionmentioning

confidence: 99%

Study on the behavioral changes of a post-stroke depression rat model

Zhang

Chen

2015

Experimental and Therapeutic Medicine

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Abstract. The aim of this study was to observe the changes in the levels of learning and memory in a post-stroke depression (PSD) rat model. Forty-eight Wistar rats were randomly divided into three groups: Group A (normal group), group B (stroke group) and group C (PSD group). Each group comprised 16 rats. Three and 7 days after successful modeling, the open-field, sucrose solution consumption and forced swimming tests were performed, so as to evaluate behavioral changes in the three groups of rats. The sucrose solution consumption of the rats in group B was lower than that in group A in the tests at the two time-points, but only the difference after 7 days was statistically significant (P<0.05). The sucrose solution consumption of the rats in group C was lower than the consumption of those in groups A and B, and the differences were statistically significant (P<0.05). The open-field test results showed that the horizontal and vertical activity scores of the rats in group B were significantly lower than those of the rats in group A (P<0.05). Furthermore, the two test levels and the vertical activity scores of the rats in group C were significantly lower than those of the rats in groups A and B (P<0.05). The immobility time of the rats in the forced swimming test was higher in group B than that in group A at the two time-points, but the difference was only statistically significant after 7 days (P<0.05). The immobility time of the rats in group C was significantly higher than that in groups A and B (P<0.01). In conclusion, rats with PSD exhibited a significantly reduced memory capacity and altered behavior. The changes in the PSD rats were more severe than those in the rats in the stroke group.

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“…Assessments were performed immediately before and after each condition by a blinded rater. They revealed the statistically significant pain reduction in both (1) the active tDCS plus active TENS condition and (2) the active tDCS plus sham TENS condition (pain reduction 37%, p=0.004; 16%, p=0.014 respectively), but not the sham tDCS plus sham TENS condition (pain increase 2%, p=0.35) [22].…”

Section: The Clinical Application Of Tdcs In Anti-neuropathic Effectmentioning

confidence: 99%

“…Boggio et al [22] completed a RCT using a crossover design to investigate the analgesic effect of a single session of active tDCS plus active TENS; active tDCS plus sham TENS; and sham tDCS plus sham TENS. The TENS electrodes were positioned 6 cm apart and centered over the site that elicited most pain on palpation during examination.…”

Section: The Clinical Application Of Tdcs In Anti-neuropathic Effectmentioning

confidence: 99%

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Transcranial Direct Current Stimulation in Neuropathic Pain

Ngernyam¹

2014

J Pain Relief

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Neuropathic pain (NP) is one of the most common problems contributing to suffering and disability worldwide. Unfortunately, NP is also largely refractory to treatments, with a large number of patients continuing to report significant pain even when they are receiving recommended medications and physical therapy. Thus, there remains an urgent need for additional effective treatments. In recent years, nonpharmacologic brain stimulation techniques have emerged as potential therapeutic options. Many of these techniques and procedures -such as transcranial magnetic stimulation, spinal cord stimulation, deep brain stimulation, and motor cortical stimulation -have very limited availability, particularly in developing countries. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation procedure that has shown promise for effectively treating NP, and also has the potential to be widely available. This review describes tDCS and the tDCS procedures and principles that may be helpful for treating NP. The findings indicate that the analgesic benefits of tDCS can occur both during stimulation and beyond the time of stimulation. The mechanisms of cortical modulation by tDCS may involve various activities in neuronal networks such as increasing glutamine and glutamate under the stimulating electrode, effects on the μ-opioid receptor, and restoration of the defective intracortical inhibition. Additional research is needed to determine (1) the factors that may moderate the efficacy of tDCS, (2) the dose (e.g. number and frequency of treatment sessions) that results in the largest benefits and (3) the long-term effects of tDCS treatment.

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Transcranial DC Stimulation Coupled With TENS for the Treatment of Chronic Pain

Abstract: The results of this pilot study suggest that the combination of TENS with tDCS has a superior effect compared with tDCS alone.

Cited by 109 publications

References 21 publications

Analgesic Effect of Transcranial Direct Current Stimulation on Central Post-Stroke Pain

Analgesic Effect of Transcranial Direct Current Stimulation on Central Post-Stroke Pain

Study on the behavioral changes of a post-stroke depression rat model

Transcranial Direct Current Stimulation in Neuropathic Pain

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