scholarly journals Transcranial direct current stimulation (a-tCDS) after subacromial injections in patients with subacromial pain syndrome: a randomized controlled pilot study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Samuel Larrivée ◽  
Frédéric Balg ◽  
Guillaume Léonard ◽  
Sonia Bédard ◽  
Michel Tousignant ◽  
...  

Abstract Background Subacromial pain syndrome (SAPS) is a common complaint in orthopaedics. Subacromial corticosteroid injections (CSI) can relieve pain in the short term. Anodal transcranial direct current stimulation (a-tDCS) has been used for symptomatic pain relief in a variety of chronic pain conditions. The aim of this pilot study was to assess whether the application a-tDCS could enhance the symptomatic relief provided by CSI in patients affected by SAPS. Methods Thirty-eight participants (18 to 65-year-old) suffering from SAPS were recruited to have a CSI and randomly allocated to receive, 1 weeks post CSI, real a-tDCS (r-tDCS), sham tDCS (s-tDCS) or no intervention (Control). Upper limb function was measured 1 week prior to the CSI, at the 2- and 4-week follow-ups using self-administered questionnaires and physical measures. Self-reported pain and activity during each day were logged by the participants using visual analog scales (VAS). Differences between groups were tested using repeated-measures ANOVAs. Results Pain VAS and the Single Assessment Numeric Evaluation scale (SANE) showed significant improvement from baseline 2 weeks and 4 weeks after CSI in all groups (p < 0.05). There were no significant group X time interaction 2 weeks following tDCS treatment in any of the variables. Conclusion All groups showed significant improvement in pain VAS and SANE scores following the CSI. One session of a-tDCS treatment 2 weeks following CSI did not result in any additive or potentializing effects when compared to a s-tDCS or a control group. Trial registration ClinicalTrials.gov, NCT03967574. Registered 30 May 2019 - Retrospectively registered.

2020 ◽  
pp. 1-13
Author(s):  
Raed A. Alharbi ◽  
Saleh A. Aloyuni ◽  
Faizan Kashoo ◽  
Mohamed I. Waly ◽  
Harpreet Singh ◽  
...  

Abstract Objective: Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS). Methods: A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA. Results: Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group. Conclusion: These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.


2021 ◽  
pp. 003151252110212
Author(s):  
Alexandre Moreira ◽  
Daniel Gomes da Silva Machado ◽  
Marom Bikson ◽  
Gozde Unal ◽  
Paul S. Bradley ◽  
...  

This study investigated the effect of transcranial direct current stimulation (tDCS) combined with a recovery training session on the well-being and self-perceived recovery of professional female soccer players after official matches. Data from 13 world-class players were analyzed after participating in four official soccer matches of the first division of the Brazilian Women’s Soccer Championship (7-, 10-, and 13-day intervals). We applied anodal tDCS (a-tDCS) over the left dorsolateral prefrontal cortex with 2 mA for 20 minutes (+F3/−F4 montage) the day after each match. Participants underwent two randomly ordered sessions of a-tDCS or sham. Players completed the Well-Being Questionnaire (WBQ) and the Total Quality Recovery (TQR) scale before each experimental condition and again the following morning. A two-way repeated-measures ANOVA showed a significant time x condition interaction on the WBQ (F(1,11)=5.21; p=0.043; ηp2=0.32), but not on the TQR (F(1,12) = 0.552; p = 0.47; ηp2 = 0.044). There was a large effect size (ES) for a-tDCS for the WBQ score (ES = 1.02; 95%CI = 0.17;1.88), and there was a moderate WBQ score increase (ES = 0.53; 95%CI = −0.29;1.34) for the sham condition. We found similar increases in the TQR score for a-tDCS (ES = 1.50; 95%CI = 0.63–2.37) and the sham condition (ES = 1.36; 95%CI = 0.51–2.22). These results suggest that a-tDCS (+F3/−F4 montage) combined with a recovery training session may slightly improve perceived well-being beyond the level of improvement after only the recovery training session among world-class female soccer players. Prior to widely adopting this recovery approach, further study is needed with larger and more diverse samples, including for female teams of different performance levels.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Suzanne Babyar ◽  
Taiza Santos-Pontelli ◽  
Tenysson Will-Lemos ◽  
Suleimy Mazin ◽  
Dylan Edwards ◽  
...  

Objective: To assess the effects of 2mA transcranial Direct Current Stimulation (tDCS) over the affected Parietal-Insular-Vestibular Cortex (PIVC) on seated posture of patients with lateropulsion following stroke. We hypothesized that bilateral electrode placement over PIVC (vs active control) would produce a change in seated posture. Background: Lateropulsion following stroke (Pusher Syndrome) is characterized by lateral displacement of subjective postural vertical toward the weak side. It is caused by lesions affecting vestibular projections to the Ventral Lateral Thalamus (VLT) or projections from the VLT to the Parietal-Insular-Vestibular Cortex (PIVC). Methods: Seventeen subjects with Burke Lateropulsion Scale scores ≥ 2 within 30 days of an ischemic stroke signed an IRB-approved consent. They received 2mA tDCS delivered using 25cm 2 saline soaked sponge electrodes via one of two montages: Test (anode over the affected PIVC and cathode opposite PIVC) versus Active Control (anode over the affected PIVC and cathode over the opposite supra-orbital region). PIVC was defined using EEG 10/20 coordinates. Seated medial-lateral center of pressure (COP-X) was measured using a custom-designed chair mounted on an AMTI™ analog-to-digital forceplate. An inclinometer strapped to the chest and aligned with the sternum measured lateral trunk tilt. Data were collected prior to, then at 5, 10, and 15 minutes during tDCS and 5 min following tDCS. Results: Repeated Measures Analysis of Variance rejected the hypothesis of an interaction between Montage and Time for: mean COP-X displacement (in) (Wilks’ λ F = 0.647 df =(4, 13), P = 0.639); mean speed of COP-X (in/s) (Wilks’ λ F = 0.740 df =(4, 13), P =0.581); mean inclinometer tilt (degrees) (Wilks’ λ F = 0.740 df =(4, 13), P =0.581). Conclusion: Neither tDCS montage showed improvement in COP-X displacement, COP-X movement velocity or inclinometer readings. These negative results are important to encourage the development of alternative tDCS stimulation parameters or identification of alternative cortical or vestibular tDCS targets for the treatment of Lateropulsion Following Stroke.


Author(s):  
Vincent Cabibel ◽  
Makii Muthalib ◽  
Jérôme Froger ◽  
Stéphane Perrey

Repeated transcranial magnetic stimulation (rTMS) is a well-known clinical neuromodulation technique, but transcranial direct-current stimulation (tDCS) is rapidly growing interest for neurorehabilitation applications. Both methods (contralesional hemisphere inhibitory low-frequency: LF-rTMS or lesional hemisphere excitatory anodal: a-tDCS) have been employed to modify the interhemispheric imbalance following stroke. The aim of this pilot study was to compare aHD-tDCS (anodal high-definition tDCS) of the left M1 (2 mA, 20 min) and LF-rTMS of the right M1 (1 Hz, 20 min) to enhance excitability and reduce inhibition of the left primary motor cortex (M1) in five healthy subjects. Single-pulse TMS was used to elicit resting and active (low level muscle contraction, 5% of maximal electromyographic signal) motor-evoked potentials (MEPs) and cortical silent periods (CSPs) from the right and left extensor carpi radialis muscles at Baseline, immediately and 20 min (Post-Stim-20) after the end of each stimulation protocol. LF-rTMS or aHD-tDCS significantly increased right M1 resting and active MEP amplitude at Post-Stim-20 without any CSP modulation and with no difference between methods. In conclusion, this pilot study reported unexpected M1 excitability changes, which most likely stems from variability, which is a major concern in the field to consider.


2018 ◽  
Vol 51 (4) ◽  
pp. 252-258
Author(s):  
Minah Kim ◽  
Tak Hyung Lee ◽  
Wu Jeong Hwang ◽  
Tae Young Lee ◽  
Jun Soo Kwon

Background. The reduced amplitude, prolonged latency, and increased intertrial variability of auditory P300 have been consistently reported in relation to the symptomatic severity of schizophrenia. This study investigated whether auditory P300 event-related potentials can be used as an objective indicator of symptomatic improvement by transcranial direct current stimulation (tDCS) in patients with schizophrenia. Methods. Ten patients with schizophrenia received 20 minutes of 2-mA tDCS twice a day for 5 consecutive weekdays. The anode was placed over the left dorsolateral prefrontal cortex, and the cathode was placed over the left temporo-parietal cortex. The Positive and Negative Syndrome Scale (PANSS) and the auditory P300 were measured for each participant at baseline and after the completion of the tDCS applications. Results. The participants showed significant improvement in the positive and negative symptoms as indexed by change in the PANSS scores by the tDCS. The P300 amplitude, latency, and intertrial variability did not statistically significantly differ after the tDCS application. However, a significant association was observed between the reduced P300 intertrial variability and improvement in the positive symptoms by tDCS. In addition, the changes in both the P300 latency and intertrial variability were significantly correlated with reduced negative symptoms after the tDCS application. Conclusions. Although this pilot study is limited by the small sample size and lack of a sham control, the results suggest that auditory P300 may be a putative marker reflecting the effect of tDCS on the positive and negative symptoms of schizophrenia.


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