Transcranial Direct Current Stimulation to Prevent and Treat Surgery-Induced Opioid Dependence: A Systematic Review

Gallucci, Alessia; Lucena, Pedro H.; Martens, Géraldine; Thibaut, Aurore; Fregni, Felipe

doi:10.2217/pmt-2018-0053

Cited by 4 publications

(3 citation statements)

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“…Wang et al (2016) reported a reduction of 36.7% in craving for heroin after watching a real video of heroin use in individuals who were addicted in the past and were in abstinence for at least 1.5 years. Perhaps more interestingly was Gallucci et al (2019) findings related to pain and analgesic use in postoperative contexts, based on seven studies. Although only one study in postoperative acute pain found reductions in pain perception after the procedure hallux valgus surgery (Ribeiro et al, 2017), there were significant reductions in patient-controlled analgesia (PCA) method in six studies (Borckardt et al, 2011, 2013, 2017; Dubois et al, 2013; Glaser et al, 2016; Khedr et al, 2017).…”

Section: Evidence Of Tdcs Impact On Painmentioning

confidence: 98%

“…This effect of tDCS was demonstrated to prevent both the disengagement of the DPIS and the summation effect on pain scores during the cold pressor test (Braulio et al, 2018). When focusing on opioid dependence, a recent review (Gallucci et al, 2019) found only one study that used tDCS. Wang et al (2016) reported a reduction of 36.7% in craving for heroin after watching a real video of heroin use in individuals who were addicted in the past and were in abstinence for at least 1.5 years.…”

Section: Evidence Of Tdcs Impact On Painmentioning

confidence: 99%

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Transcranial Direct Current Stimulation to Improve the Dysfunction of Descending Pain Modulatory System Related to Opioids in Chronic Non-cancer Pain: An Integrative Review of Neurobiology and Meta-Analysis

et al. 2019

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Background: Opioid long-term therapy can produce tolerance, opioid-induced hyperalgesia (OIH), and it induces dysfunction in pain descending pain inhibitory system (DPIS).Objectives: This integrative review with meta-analysis aimed: (i) To discuss the potential mechanisms involved in analgesic tolerance and opioid-induced hyperalgesia (OIH). (ii) To examine how the opioid can affect the function of DPIS. (ii) To show evidence about the tDCS as an approach to treat acute and chronic pain. (iii) To discuss the effect of tDCS on DPIS and how it can counter-regulate the OIH. (iv) To draw perspectives for the future about the tDCS effects as an approach to improve the dysfunction in the DPIS in chronic non-cancer pain.Methods: Relevant published randomized clinical trials (RCT) comparing active (irrespective of the stimulation protocol) to sham tDCS for treating chronic non-cancer pain were identified, and risk of bias was assessed. We searched trials in PubMed, EMBASE and Cochrane trials databases. tDCS protocols accepted were application in areas of the primary motor cortex (M1), dorsolateral prefrontal cortex (DLPFC), or occipital area.Results: Fifty-nine studies were fully reviewed, and 24 with moderate to the high-quality methodology were included. tDCS improved chronic pain with a moderate effect size [pooled standardized mean difference; −0.66; 95% confidence interval (CI) −0.91 to −0.41]. On average, active protocols led to 27.26% less pain at the end of treatment compared to sham [95% CI; 15.89–32.90%]. Protocol varied in terms of anodal or cathodal stimulation, areas of stimulation (M1 and DLPFC the most common), number of sessions (from 5 to 20) and current intensity (from 1 to 2 mA). The time of application was 20 min in 92% of protocols.Conclusion: In comparison with sham stimulation, tDCS demonstrated a superior effect in reducing chronic pain conditions. They give perspectives that the top-down neuromodulator effects of tDCS are a promising approach to improve management in refractory chronic not-cancer related pain and to enhance dysfunctional neuronal circuitries involved in the DPIS and other pain dimensions and improve pain control with a therapeutic opioid-free. However, further studies are needed to determine individualized protocols according to a biopsychosocial perspective.

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Section: Evidence Of Tdcs Impact On Painmentioning

confidence: 98%

Section: Evidence Of Tdcs Impact On Painmentioning

confidence: 99%

Transcranial Direct Current Stimulation to Improve the Dysfunction of Descending Pain Modulatory System Related to Opioids in Chronic Non-cancer Pain: An Integrative Review of Neurobiology and Meta-Analysis

et al. 2019

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“…Non-invasive brain modulation techniques such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) are emerging as complementary pain treatment options, both for postoperative [ 1 , 2 ] and chronic pain [ 3 ]. Compared to rTMS, tDCS has the advantage of being cheap, easy to administer, and well tolerated, making it an ideal candidate for clinical use [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Multichannel transcranial direct current stimulation over the left dorsolateral prefrontal cortex may modulate the induction of secondary hyperalgesia, a double-blinded cross-over study in healthy volunteers

et al. 2022

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Background Central sensitization is thought to play a critical role in the development of chronic pain, and secondary mechanical hyperalgesia is considered one of its hall-mark features. Consequently, interventions capable of modulating its development could have important therapeutic value. Non-invasive neuromodulation of the left dorsolateral prefrontal cortex (DLPFC) has shown potential to reduce pain, both in healthy volunteers and in patients. Whether it can modulate the induction of central sensitization, however, is less well known. Objective To determine whether multifocal transcranial direct current stimulation (tDCS) targeting the left DLPFC affects the development of secondary mechanical hyperalgesia. Methods In this within-subjects, cross-over, double-blinded study, eighteen healthy volunteers participated in three experimental sessions. After 20 minutes of either anodal, cathodal, or sham multichannel tDCS over the left DLPFC, secondary mechanical hyperalgesia was induced using high-frequency electrical stimulation (HFS) of the volar forearm. We assessed intensity of perception to 128 mN mechanical pinprick stimuli at baseline and up to 240 minutes after HFS. We also mapped the area of mechanical hyperalgesia. Results HFS resulted in a robust and unilateral increase in the intensity of perception to mechanical pinprick stimuli at the HFS arm, which was not different between tDCS stimulation conditions. However, the area of hyperalgesia was reduced after anodal tDCS compared to sham. Conclusion Anodal tDCS over the left DLPFC modestly modulates the size of the HFS-induced area of secondary mechanical hyperalgesia, suggesting that non-invasive neuromodulation targeting the left DLPFC may be a potential intervention to limit the development of central sensitization.

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Transcranial Direct Current Stimulation in Substance Use Disorders

Nakamura-Palacios

Ronchete

Felippe

et al. 2021

Transcranial Direct Current Stimulation in Neuropsychiatric Disorders

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Transcranial Direct Current Stimulation to Prevent and Treat Surgery-Induced Opioid Dependence: A Systematic Review

Cited by 4 publications

References 115 publications

Transcranial Direct Current Stimulation to Improve the Dysfunction of Descending Pain Modulatory System Related to Opioids in Chronic Non-cancer Pain: An Integrative Review of Neurobiology and Meta-Analysis

Transcranial Direct Current Stimulation to Improve the Dysfunction of Descending Pain Modulatory System Related to Opioids in Chronic Non-cancer Pain: An Integrative Review of Neurobiology and Meta-Analysis

Multichannel transcranial direct current stimulation over the left dorsolateral prefrontal cortex may modulate the induction of secondary hyperalgesia, a double-blinded cross-over study in healthy volunteers

Transcranial Direct Current Stimulation in Substance Use Disorders

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