scholarly journals Effectiveness of Transcranial Direct Current Stimulation and Pharmacotherapy in Pain Management in Patients with Chronic Pain

2021 ◽  
Vol 18 (4) ◽  
Author(s):  
Atefeh Lotfi Jabali ◽  
Mina Mojtabaei ◽  
Malek Mirhashemi
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Pain Clinic ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Statistical Population ◽  
Direct Current Stimulation ◽  
Significant Difference

Background: A variety of pharmacological and nonpharmacological methods are used to treat chronic pain. Transcranial direct current stimulation (tDCS) through stimulating the central and peripheral nerves is a different and promising method for the treatment of chronic pain. Objectives: The present study aimed to investigate the effectiveness of tDCS and pharmacotherapy in pain management in patients with chronic pain in Tehran, Iran. Methods: The present study followed a clinical trial design. The statistical population comprised all patients with chronic pain who were referred to Pardis Multidisciplinary Pain Clinic in Tehran within 2020 - 21. A total of 60 patients willing to participate in the study were selected using convenience sampling. The participants were randomly divided into three groups, including pharmacotherapy (treatment by gabapentin with a dosage of 600 mg twice per day), tDCS, and control (n = 20 per group). The research instrument included the McGill Pain Questionnaire. The data were analyzed using repeated-measures analysis of variance with SPSS software (version 24.0). Results: The results showed that both pharmacotherapy and tDCS interventions led to a reduction in the mean scores of pain management components, compared to the control group (P < 0.001). Furthermore, there was no significant difference between the effects of the two experimental groups on pain management components. Conclusions: The tDCS and pharmacotherapy were both shown to be effective in pain management in patients with chronic pain. Therefore, in addition to pharmacotherapy, tDCS is also recommended for the treatment of chronic pain.

scholarly journals Effect of Transcranial Direct Current Stimulation on an Individual’s Ability to Learn to Control a Brain-Computer Interface

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Erika Renda ◽  
Sarah Amirali Karmali ◽  
Ivona Yordanova ◽  
Shira Schwartz ◽  
Yacine Mahdid ◽  
...  
Keyword(s):  
Motor Imagery ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Brain Activity ◽  
Control Group ◽  
Motor Impairments ◽  
Direct Current Stimulation ◽  
Electrical Brain Activity ◽  
Significant Difference ◽  
Experimental Group

Purpose: Brain-computer interfaces (BCI) are systems which enable direct communication between a brain and an external device by translating electrical brain activity into meaningful output. This technology can be used by individuals with motor impairments to interact and communicate with their external environment. BCIs based upon manipulating the sensorimotor rhythm (SMR) through motor imagery have lengthy learning periods, which present a significant barrier to using this technology. We hypothesize that this learning period will be significantly reduced by transcranial direct current stimulation (tDCS), which temporarily augments cortical excitability.Methods: Participants were assigned into two groups - the experimental group, which received tDCS, and a control group, which received sham stimulation. Following tDCS, the participants used a SMR-based BCI to move a falling ball to hit targets that appeared on the left or right side of screen. The effect of tDCS was assessed by comparing the overall task accuracy and the SMR change during motor imagery between the two groups .Results: The experimental group was significantly more accurate in controlling the BCI than the control group (p = 0.021); however, there was no significant difference between groups in the SMR change upon motor imagery (p = 0.22). Conclusions. tDCS can be used to improve the performance of healthy individuals learning to use an SMR-based BCI. 

scholarly journals Comparison of the Effect of Transcranial Direct Current Stimulation, Neurofeedback, and Neuro-Linguistic Programming on Reducing the Rate of Depression, Anxiety, and Stress

2021 ◽  
Vol 10 (4) ◽  
Author(s):  
Mozhdeh Mirmoradzehi Sibi ◽  
Mahmoud Shirazi ◽  
Farhad Kahrazei ◽  
Zahra Ghiasi
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Common Mental Disorders ◽  
Sampling Procedure ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Human Beings ◽  
Statistical Population ◽  
Direct Current Stimulation ◽  
Treatment Of Depression

Background: Depression, anxiety, and stress are the most common mental disorders almost experienced by human beings. Nowadays, due to the coronavirus outbreak, people are becoming more vulnerable to these disorders. Objectives: The present study aimed to investigate the comparison of the effect of 3 treatment methods, named neuro-linguistic programming (NLP), transcranial direct current stimulation (tDCS), and neurofeedback (NFB), on patients suffering from disorders mentioned above. Methods: The research design selected for the present investigation was a quasi-experimental method consisting of pretest and posttest given to 3 experimental groups [i.e., NFB (n = 15), tDCS (n = 15), and NLP (n = 15)] and 1 control group (n = 15). The statistical population was included patients who had been referred to mental health experts at comprehensive health service centers in Zahedan, Iran (2020). The sampling procedure was based on a simple random method with a population of 68 subjects (60 main samples and 8 alternatives). Following the completion of the Depression Anxiety Stress Scales-21 (DASS-21) questionnaire, data were collected and then analyzed step by step using SPSS version 23. Results: The results of the multivariate analysis of covariance (MANCOVA) test showed that there would be no significant decrease in the mean scores of depressions, anxiety, and stress between the pre-and posttest scores of the subjects in the treatment groups (P < 0.0001). Conclusions: NLP, tDCS, and NFB were significantly effective in the treatment of depression, anxiety, and stress. Considering the importance of the findings, non-pharmacological methods could be effective in the treatment of depression, anxiety, and stress.

scholarly journals Gender-specific modulation of short-term neuroplasticity in the visual cortex induced by transcranial direct current stimulation

2008 ◽  
Vol 25 (1) ◽  
pp. 77-81 ◽  
Author(s):  
LEILA CHAIEB ◽  
ANDREA ANTAL ◽  
WALTER PAULUS
Keyword(s):  
Sex Differences ◽  
Visual Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cortical Excitability ◽  
Gonadal Hormones ◽  
Study Data ◽  
Short Term ◽  
Direct Current Stimulation ◽  
Significant Difference

Transcranial direct current stimulation (tDCS) is a non-invasive method of modulating levels of cortical excitability. In this study, data gathered over a number of previously conducted experiments before and after tDCS, has been re-analyzed to investigate correlations between sex differences with respect to neuroplastic effects. Visual evoked potentials (VEPs), phosphene thresholds (PTs), and contrast sensitivity measurements (CSs) are used as indicators of the excitability of the primary visual cortex. The data revealed that cathodally induced excitability effects 10 min post stimulation with tDCS, showed no significant difference between genders. However, stimulation in the anodal direction revealed sex-specific effects: in women, anodal stimulation heightened cortical excitability significantly when compared to the age-matched male subject group. There was no significant difference between male and female subjects immediately after stimulation. These results indicate that sex differences exist within the visual cortex of humans, and may be subject to the influences of modulatory neurotransmitters or gonadal hormones which mirror short-term neuroplastic effects.

scholarly journals USING TRANSCRANIAL DIRECT CURRENT STIMULATION TO REDUCE CHRONIC PAIN IN ELDERLY INDIVIDUALS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 240-240
Author(s):  
M. Harvey ◽  
M. Martel ◽  
F. Houde ◽  
I. Daguet ◽  
M. Séguin ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Elderly Individuals ◽  
Direct Current Stimulation

scholarly journals Transcranial direct current stimulation improves action-outcome monitoring in schizophrenia spectrum disorder

2020 ◽  
Author(s):  
Benjamin Straube ◽  
Bianca M van Kemenade ◽  
Tilo Kircher ◽  
Rasmus Schülke
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Efference Copy ◽  
Spectrum Disorder ◽  
Control Group ◽  
Schizophrenia Spectrum Disorder ◽  
Direct Current Stimulation ◽  
Schizophrenia Spectrum ◽  
Outcome Monitoring ◽  
Healthy Control

Abstract Patients with schizophrenia spectrum disorder often demonstrate impairments in action-outcome monitoring. Passivity phenomena and hallucinations, in particular, have been related to impairments of efference copy-based predictions which are relevant for the monitoring of outcomes produced by voluntary action. Frontal transcranial direct current stimulation has been shown to improve action-outcome monitoring in healthy subjects. However, whether transcranial direct current stimulation can improve action monitoring in patients with schizophrenia spectrum disorder remains unknown. We investigated whether transcranial direct current stimulation can improve the detection of temporal action-outcome discrepancies in patients with schizophrenia spectrum disorder. On 4 separate days, we applied sham or left cathodal/right anodal transcranial direct current stimulation in a randomised order to frontal (F3/F4), parietal (CP3/CP4) and frontoparietal (F3/CP4) areas of 19 patients with schizophrenia spectrum disorder and 26 healthy control subjects. Action-outcome monitoring was assessed subsequent to 10 min of sham/transcranial direct current stimulation (1.5 mA). After a self-generated (active) or externally generated (passive) key press, subjects were presented with a visual outcome (a dot on the screen), which was presented after various delays (0–417 ms). Participants had to detect delays between the key press and the visual consequence. Symptom subgroups were explored based on the presence or absence of symptoms related to a paranoid-hallucinatory syndrome. In general, delay-detection performance was impaired in the schizophrenia spectrum disorder compared to the healthy control group. Interaction analyses showed group-specific (schizophrenia spectrum disorder vs healthy control group) and symptom-specific (with/without relevant paranoid-hallucinatory symptoms) transcranial direct current stimulation effects. Post-hoc tests revealed that frontal transcranial direct current stimulation improved the detection of long delays in active conditions and reduced the proportion of false alarms in undelayed trials of the passive condition in patients. The patients with no or few paranoid-hallucinatory symptoms benefited especially from frontal transcranial direct current stimulation in active conditions, while improvement in the patients with paranoid-hallucinatory symptoms was predominantly reflected in reduced false alarm rates in passive conditions. These data provide some first evidence for the potential utility of transcranial direct current stimulation in improving efference copy mechanisms and action-outcome monitoring in schizophrenia spectrum disorder. Current data indicate that improving efference copy-related processes can be especially effective in patients with no or few positive symptoms, while intersensory matching (i.e. task-relevant in passive conditions) could be more susceptible to improvement in patients with paranoid-hallucinatory symptoms.

Additive Analgesic Effect of Transcranial Direct Current Stimulation Together with Mirror Therapy for the Treatment of Phantom Pain

Pain Medicine ◽  
2020 ◽  
Author(s):  
Nitza Segal ◽  
Dorit Pud ◽  
Hagai Amir ◽  
Motti Ratmansky ◽  
Pora Kuperman ◽  
...  
Keyword(s):  
Treatment Group ◽  
Pain Intensity ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Analgesic Effect ◽  
Secondary Outcome ◽  
Mcgill Pain Questionnaire ◽  
Phantom Pain ◽  
Mirror Therapy ◽  
Direct Current Stimulation

Abstract Objective Current analgesic treatments for phantom pain are not optimal. One well-accepted yet limited nonpharmacological option is mirror therapy, which is thought to counterbalance abnormal plasticity. Transcranial direct current stimulation (tDCS) is an emerging approach believed to affect the membrane potential and activity threshold of cortical neurons. tDCS analgesic effectiveness, however, is mild and short, rendering it a noneffective stand-alone treatment. This study aimed to assess if a combination of mirror therapy with tDCS results in a superior analgesic effect as compared with mirror therapy alone in patients suffering from phantom pain due to recent amputation. Design Following ethical approval, eligible patients provided informed consent and were randomly assigned to a study treatment group that continued for 2 weeks (once daily): 1) mirror therapy; 2) mirror therapy and sham tDCS; or 3) mirror therapy and tDCS. Assessments were done before treatment; at the end of treatment weeks 1 and 2; and at 1 week, 1 month, and 3 months following treatment. The primary outcome measure was pain intensity. Secondary measures were derived from the Short Form McGill Pain Questionnaire and the Brief Pain Inventory. Results Thirty patients were recruited, and 29 patients completed the study. Three months following treatment, pain intensity was significantly (P&lt;0.001) reduced in the combined treatment group (reduction of 5.4±3.3 points) compared with the other study arms (mirror therapy, 1.2±1.1; mirror therapy and sham tDCS, 2.7±3.2). All secondary outcome results were in line with these findings. Conclusions Combining tDCS with mirror therapy results in a robust long-lasting analgesic effect. These encouraging findings may contribute to the understanding of the underlying mechanisms of phantom pain.

scholarly journals Transcranial direct current stimulation in management of pain, mood, functionality, and quality of life in patients undergoing hemodialysis: a study protocol for a double-blind controlled randomized trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Artur Quintiliano ◽  
Tayanne Oehmen ◽  
Gianna Mastroianni Kirsztajn ◽  
Rodrigo Pegado
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Pharmacological Treatment ◽  
Controlled Trial ◽  
Double Blind ◽  
Direct Current Stimulation ◽  
Continuous Current

Abstract Background Persistent pain can lead to incapacitation requiring long-term pharmacological treatment. Up to 82% of chronic kidney disease (CKD) patients undergoing hemodialysis (HD) have chronic pain and most do not respond to usual medication. Advances in non-pharmacological treatments are necessary to promote pain relief without side effects and to restore functionality. Transcranial direct current stimulation (tDCS) promises to be a novel, cost-efficient, non-pharmacological treatment for CKD patients with chronic pain. In this study, we hypothesize that tDCS could improve pain, depression, functionality, and quality of life in patients with CKD undergoing HD. Methods/design We describe a single-center, parallel-design, double blind randomized, sham-controlled trial. Forty-five subjects with CKD undergoing HD will be randomized to a motor cortex (M1), a dorso lateral prefrontal cortex (DLPFC), or a sham group. A total of ten sessions will be administered to participants over 4 weeks using a monophasic continuous current with an intensity of 2 mA for 20 min. Participants will be evaluated at baseline, immediately after the tenth session, and at 1 week and 4 weeks of follow-up after the intervention. Pain, depression, functionality, and quality of life will be evaluated. Discussion The results from this study will provide initial clinical evidence on the efficacy and safety of tDCS in patients with CKD undergoing HD. Trial registration Brazilian Clinical Trials Registry/Registro Brasileiro de Ensaios Clínicos (ensaiosclinicos.gov.br), 1111–1216-0137. Registered on 20 June 2018.

scholarly journals Patient-Controlled Intravenous Morphine Analgesia Combined with Transcranial Direct Current Stimulation for Post-Thoracotomy Pain: A Cost-Effectiveness Study and A Feasibility for Its Future Implementation

2020 ◽  
Vol 17 (3) ◽  
pp. 816 ◽  
Author(s):  
Nemanja Rancic ◽  
Katarina Mladenovic ◽  
Nela V. Ilic ◽  
Viktorija Dragojevic-Simic ◽  
Menelaos Karanikolas ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cost Effectiveness Analysis ◽  
Control Group ◽  
Morphine Analgesia ◽  
Direct Current Stimulation ◽  
Effectiveness Analysis ◽  
Intravenous Morphine

This prospective randomized study aims to evaluate the feasibility and cost-effectiveness of combining transcranial direct current stimulation (tDCS) with patient controlled intravenous morphine analgesia (PCA-IV) as part of multimodal analgesia after thoracotomy. Patients assigned to the active treatment group (a-tDCS, n = 27) received tDCS over the left primary motor cortex for five days, whereas patients assigned to the control group (sham-tDCS, n = 28) received sham tDCS stimulations. All patients received postoperative PCA-IV morphine. For cost-effectiveness analysis we used data about total amount of PCA-IV morphine and maximum visual analog pain scale with cough (VASP-Cmax). Direct costs of hospitalization were assumed as equal for both groups. Cost-effectiveness analysis was performed with the incremental cost-effectiveness ratio (ICER), expressed as the incremental cost (RSD or US$) per incremental gain in mm of VASP-Cmax reduction. Calculated ICER was 510.87 RSD per VASP-Cmax 1 mm reduction. Conversion on USA market (USA data 1.325 US$ for 1 mg of morphine) revealed ICER of 189.08 US$ or 18960.39 RSD/1 VASP-Cmax 1 mm reduction. Cost-effectiveness expressed through ICER showed significant reduction of PCA-IV morphine costs in the tDCS group. Further investigation of tDCS benefits with regards to reduction of postoperative pain treatment costs should also include the long-term benefits of reduced morphine use.

scholarly journals Verbal Fluency in Mild Alzheimer’s Disease: Transcranial Direct Current Stimulation over the Dorsolateral Prefrontal Cortex

2021 ◽  
pp. 1-11
Author(s):  
Daniela Smirni ◽  
Massimiliano Oliveri ◽  
Eliana Misuraca ◽  
Angela Catania ◽  
Laura Vernuccio ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Verbal Fluency ◽  
Dorsolateral Prefrontal Cortex ◽  
Control Group ◽  
Direct Current Stimulation ◽  
Cathodal Tdcs ◽  
Dorsolateral Prefrontal ◽  
The Right

Background: Recent studies showed that in healthy controls and in aphasic patients, inhibitory trains of repetitive transcranial magnetic stimulation (rTMS) over the right prefrontal cortex can improve phonemic fluency performance, while anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex can improve performance in naming and semantic fluency tasks. Objective: This study aimed at investigating the effects of cathodal tDCS over the left or the right dorsolateral prefrontal cortex (DLPFC) on verbal fluency tasks (VFT) in patients with mild Alzheimer’s disease (AD). Methods: Forty mild AD patients participated in the study (mean age 73.17±5.61 years). All participants underwent cognitive baseline tasks and a VFT twice. Twenty patients randomly received cathodal tDCS to the left or the right DLPFC, and twenty patients were assigned to a control group in which only the two measures of VFT were taken, without the administration of the tDCS. Results: A significant improvement of performance on the VFT in AD patients was present after tDCS over the right DLPFC (p = 0.001). Instead, no difference was detected between the two VFTs sessions after tDCS over the left DLPFC (p = 0.42). Furthermore, these results cannot be related to task learning effects, since no significant difference was found between the two VFT sessions in the control group (p = 0.73). Conclusion: These data suggest that tDCS over DLPFC can improve VFT performance in AD patients. A hypothesis is that tDCS enhances adaptive patterns of brain activity between functionally connected areas.

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