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Anodal transcranial direct current stimulation of the motor cortex ameliorates chronic pain and reduces short intracortical inhibition.
J Pain Symptom Manage 2010; 39(5):890-903JP

Abstract

CONTEXT

Consecutive sessions of transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) may be a suitable therapy to treat chronic pain, as it can modulate neural activities in the stimulated and interconnected regions.

OBJECTIVES

The present study investigated the analgesic effect of five consecutive days of anodal/sham tDCS using subjective (visual analog scale [VAS]) and objective (cortical excitability measured by transcranial magnetic stimulation [TMS]) measurements.

METHODS

Patients with therapy-resistant chronic pain syndromes (trigeminal neuralgia, poststroke pain syndrome, back pain, fibromyalgia) participated. As this clinical trial was an exploratory study, statistical analyses implemented exploratory methods. Twelve patients, who underwent both anodal and sham tDCS, were analyzed using a crossover design. An additional nine patients had only anodal or sham stimulation. tDCS was applied over the hand area of the M1 for 20 minutes, at 1mA for five consecutive days, using a randomized, double-blind design. Pain was assessed daily using a VAS rating for one month before, during, and one month post-stimulation. M1 excitability was determined using paired-pulse TMS.

RESULTS

Anodal tDCS led to a greater improvement in VAS ratings than sham tDCS, evident even three to four weeks post-treatment. Decreased intracortical inhibition was demonstrated after anodal stimulation, indicating changes in cortico-cortical excitability. No patient experienced severe adverse effects; seven patients suffered from light headache after anodal and six after sham stimulation.

CONCLUSION

Results confirm that five daily sessions of tDCS over the hand area of the M1 can produce long-lasting pain relief in patients with chronic pain.

Authors+Show Affiliations

Department of Clinical Neurophysiology, Georg-August University, 37075 Göttingen, Germany. Aantal@gwdg.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20471549

Citation

Antal, Andrea, et al. "Anodal Transcranial Direct Current Stimulation of the Motor Cortex Ameliorates Chronic Pain and Reduces Short Intracortical Inhibition." Journal of Pain and Symptom Management, vol. 39, no. 5, 2010, pp. 890-903.
Antal A, Terney D, Kühnl S, et al. Anodal transcranial direct current stimulation of the motor cortex ameliorates chronic pain and reduces short intracortical inhibition. J Pain Symptom Manage. 2010;39(5):890-903.
Antal, A., Terney, D., Kühnl, S., & Paulus, W. (2010). Anodal transcranial direct current stimulation of the motor cortex ameliorates chronic pain and reduces short intracortical inhibition. Journal of Pain and Symptom Management, 39(5), pp. 890-903. doi:10.1016/j.jpainsymman.2009.09.023.
Antal A, et al. Anodal Transcranial Direct Current Stimulation of the Motor Cortex Ameliorates Chronic Pain and Reduces Short Intracortical Inhibition. J Pain Symptom Manage. 2010;39(5):890-903. PubMed PMID: 20471549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anodal transcranial direct current stimulation of the motor cortex ameliorates chronic pain and reduces short intracortical inhibition. AU - Antal,Andrea, AU - Terney,Daniella, AU - Kühnl,Stefanie, AU - Paulus,Walter, PY - 2009/03/12/received PY - 2009/09/14/revised PY - 2009/10/16/accepted PY - 2010/5/18/entrez PY - 2010/5/18/pubmed PY - 2010/8/14/medline SP - 890 EP - 903 JF - Journal of pain and symptom management JO - J Pain Symptom Manage VL - 39 IS - 5 N2 - CONTEXT: Consecutive sessions of transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) may be a suitable therapy to treat chronic pain, as it can modulate neural activities in the stimulated and interconnected regions. OBJECTIVES: The present study investigated the analgesic effect of five consecutive days of anodal/sham tDCS using subjective (visual analog scale [VAS]) and objective (cortical excitability measured by transcranial magnetic stimulation [TMS]) measurements. METHODS: Patients with therapy-resistant chronic pain syndromes (trigeminal neuralgia, poststroke pain syndrome, back pain, fibromyalgia) participated. As this clinical trial was an exploratory study, statistical analyses implemented exploratory methods. Twelve patients, who underwent both anodal and sham tDCS, were analyzed using a crossover design. An additional nine patients had only anodal or sham stimulation. tDCS was applied over the hand area of the M1 for 20 minutes, at 1mA for five consecutive days, using a randomized, double-blind design. Pain was assessed daily using a VAS rating for one month before, during, and one month post-stimulation. M1 excitability was determined using paired-pulse TMS. RESULTS: Anodal tDCS led to a greater improvement in VAS ratings than sham tDCS, evident even three to four weeks post-treatment. Decreased intracortical inhibition was demonstrated after anodal stimulation, indicating changes in cortico-cortical excitability. No patient experienced severe adverse effects; seven patients suffered from light headache after anodal and six after sham stimulation. CONCLUSION: Results confirm that five daily sessions of tDCS over the hand area of the M1 can produce long-lasting pain relief in patients with chronic pain. SN - 1873-6513 UR - https://www.unboundmedicine.com/medline/citation/20471549/Anodal_transcranial_direct_current_stimulation_of_the_motor_cortex_ameliorates_chronic_pain_and_reduces_short_intracortical_inhibition_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0885-3924(10)00158-2 DB - PRIME DP - Unbound Medicine ER -