Self-Administered Transcranial Direct Current Stimulation for Pain in Older Adults With Knee Osteoarthritis: A Phase II Randomized Sham-Controlled Trial

Author(s):  
2021 ◽  
Vol 13 ◽  
Author(s):  
Ying-Yi Liao ◽  
Mu-N Liu ◽  
Han-Cheng Wang ◽  
Vincent Walsh ◽  
Chi Ieong Lau

Introduction: Engaging in a secondary task while walking increases motor-cognitive interference and exacerbates fall risk in older adults with mild cognitive impairment (MCI). Previous studies have demonstrated that Tai Chi (TC) may improve cognitive function and dual-task gait performance. Intriguingly, with emerging studies also indicating the potential of transcranial direct current stimulation (tDCS) in enhancing such motor-cognitive performance, whether combining tDCS with TC might be superior to TC alone is still unclear. The purpose of this study was to investigate the effects of combining tDCS with TC on dual-task gait in patients with MCI.Materials and Methods: Twenty patients with MCI were randomly assigned to receive either anodal or sham tDCS, both combined with TC, for 36 sessions over 12 weeks. Subjects received 40 min of TC training in each session. During the first 20 min, they simultaneously received either anodal or sham tDCS over the left dorsolateral prefrontal cortex. Outcome measures included dual-task gait performance and other cognitive functions.Results: There were significant interaction effects between groups on the cognitive dual task walking. Compared to sham, the anodal tDCS group demonstrated a greater improvement on cadence and dual task cost of speed.Conclusion: Combining tDCS with TC may offer additional benefits over TC alone in enhancing dual-task gait performance in patients with MCI.Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [TCTR20201201007].


10.2196/11660 ◽  
2018 ◽  
Vol 7 (10) ◽  
pp. e11660 ◽  
Author(s):  
Daniela Regina Brandao Tavares ◽  
Jane Erika Frazao Okazaki ◽  
Aline Pereira Rocha ◽  
Marcia Valeria De Andrade Santana ◽  
Ana Carolina Pereira Nunes Pinto ◽  
...  

2019 ◽  
Vol 22 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Robert Suchting ◽  
Gabriela D. Colpo ◽  
Natalia P. Rocha ◽  
Hyochol Ahn

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.


Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2676-2683
Author(s):  
Robert Suchting ◽  
Shweta Kapoor ◽  
Kenneth B Mathis ◽  
Hyochol Ahn

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.


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