scholarly journals Changes in Experimental Pain Sensitivity from Using Home-Based Remotely Supervised Transcranial Direct Current Stimulation in Older Adults with Knee Osteoarthritis

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2676-2683
Author(s):  
Robert Suchting ◽  
Shweta Kapoor ◽  
Kenneth B Mathis ◽  
Hyochol Ahn
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Pressure Pain Threshold ◽  
Nonparametric Tests ◽  
Pain Modulation ◽  
Constant Current ◽  
Direct Current Stimulation ◽  
Home Based

Abstract Objective The present study examined the effects of home-based remotely supervised transcranial direct current stimulation on quantitative sensory testing measurements in older adults with knee osteoarthritis. Participants were hypothesized to experience improved pain measurements over time. Design Open-label, single-arm trial. Setting Southeast Texas between March and November 2018 at a nursing school and participant homes. Subjects Older adults (aged 50–85 years) with self-reported unilateral or bilateral knee osteoarthritis pain who met eligibility criteria set by the American College of Rheumatology. Methods The intervention was applied with a constant current intensity for 20 minutes every weekday for two weeks (10 total sessions). Quantitative measures of pain were collected three times over 10 days (days 1, 5, and 10) and included heat threshold and tolerance, pressure pain threshold, punctate mechanical pain, pain, and conditioned pain modulation. Analyses used nonparametric tests to evaluate differences between day 1 and day 10. Generalized linear mixed models were then used to evaluate change across all three time points for each measure. Bayesian inference was used to provide the posterior probability of longitudinal effects. Results Nonparametric tests found improvements in seven measures, and longitudinal models supported improvements in 10 measures, with some nonlinear effects. Conclusions The home-based, remotely supervised intervention improved quantitative measurements of pain in older adults with knee osteoarthritis. This study contributes to the growing body of literature supporting home-based noninvasive stimulation interventions.

scholarly journals The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis

2019 ◽  
Vol 22 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Robert Suchting ◽  
Gabriela D. Colpo ◽  
Natalia P. Rocha ◽  
Hyochol Ahn
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Preliminary Evidence ◽  
Analysis Of Covariance ◽  
Linear Modeling ◽  
Change Analysis ◽  
Direct Current Stimulation ◽  
Tnf Α

Transcranial direct current stimulation (tDCS) has demonstrated effectiveness in reducing clinical and experimental measures of pain in patients with chronic pain; however, research examining the mechanisms of action for the effects of tDCS has been lacking. The present study investigated the effect of active tDCS on measures of inflammation and stress. Older adults (aged 50–70 years) with knee osteoarthritis (OA) were randomly assigned to receive daily 20-min sessions of either tDCS ( n = 20) or sham tDCS ( n = 20) for 5 consecutive days. Participants provided blood samples at baseline and the end of treatment. The following measures of immune function and stress were collected: interleukin (IL)-6 and 10, tumor necrosis factor-α (TNF-α), C-reactive protein, cortisol, and β-endorphin. Generalized linear modeling evaluated each posttreatment measure as a function of tDCS group, controlling for baseline (measuring residual change, analogous to analysis of covariance). Bayesian statistical inference was used to directly quantify the probability of the effect of active tDCS. IL-6, IL-10, TNF-α, and β-endorphin demonstrated lower levels of stress and inflammation in the active tDCS group. These findings provide preliminary evidence that active (relative to sham) tDCS is associated with reduced levels of inflammation.

scholarly journals Transcranial Direct Current Stimulation Combined With Meditation for Older Adults With Knee Osteoarthritis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 205-205
Author(s):  
Hyochol Ahn ◽  
Lindsey Park ◽  
Hongyu Miao
Keyword(s):  
Older Adults ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Clinical Symptoms ◽  
Direct Current Stimulation ◽  
Knee Oa ◽  
Home Based ◽  
Common Causes ◽  
Central Pain Processing ◽  
The Brain

Abstract Osteoarthritis (OA) of the knee is one of the most common causes of pain in older adults. Recent evidence suggests that knee OA pain is characterized by alterations in central pain processing in the brain. Two nonpharmacological pain treatments, transcranial direct current stimulation (tDCS) and mindfulness-based meditation (MBM), have been shown to improve pain-related brain function in older adults with knee OA. Because tDCS promotes neuroplasticity, it may potentiate the effect of MBM that also stimulates adaptive changes in the brain. However, no studies have examined whether tDCS combined with MBM can reduce OA symptoms in older adults with knee OA. Thus, the purpose of this study was to examine the preliminary efficacy of tDCS combined with MBM in older adults with knee OA. Thirty participants with knee OA were randomly assigned to receive 10 daily sessions of home-based 2 mA tDCS combined with active MBM for 20 minutes (n=15) or sham tDCS combined with sham MBM (n=15). We measured OA-related clinical symptoms using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Participants (60% female) had a mean age of 59 years. Active tDCS combined with active MBM significantly reduced scores on the WOAMC (Cohen’s d = 0.83, P = 0.02). Participants tolerated tDCS combined with MBM well without serious adverse effects. Our findings demonstrate promising clinical efficacy of home-based tDCS combined with MBM for older adults with knee OA. Future studies with larger-scale randomized controlled trials with follow-up assessments are needed to validate our findings.

scholarly journals Can Transcranial Direct Current Stimulation Enhance Functionality in Older Adults? A Systematic Review

2021 ◽  
Vol 10 (13) ◽  
pp. 2981
Author(s):  
Andrés Pino-Esteban ◽  
Álvaro Megía-García ◽  
David Martín-Caro Álvarez ◽  
Hector Beltran-Alacreu ◽  
Juan Avendaño-Coy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Healthy Older Adults ◽  
Sham Stimulation ◽  
Direct Current Stimulation ◽  
Potential Benefits

Transcranial direct current stimulation (tDCS) is a non-invasive, easy to administer, well-tolerated, and safe technique capable of affecting brain excitability, both at the cortical and cerebellum levels. However, its effectiveness has not been sufficiently assessed in all population segments or clinical applications. This systematic review aimed at compiling and summarizing the currently available scientific evidence about the effect of tDCS on functionality in older adults over 60 years of age. A search of databases was conducted to find randomized clinical trials that applied tDCS versus sham stimulation in the above-mentioned population. No limits were established in terms of date of publication. A total of 237 trials were found, of which 24 met the inclusion criteria. Finally, nine studies were analyzed, including 260 healthy subjects with average age between 61.0 and 85.8 years. Seven of the nine included studies reported superior improvements in functionality variables following the application of tDCS compared to sham stimulation. Anodal tDCS applied over the motor cortex may be an effective technique for improving balance and posture control in healthy older adults. However, further high-quality randomized controlled trials are required to determine the most effective protocols and to clarify potential benefits for older adults.

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