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Patient-conducted anodal transcranial direct current stimulation of the motor cortex alleviates pain in trigeminal neuralgia.

Hagenacker T, Bude V, Naegel S, Holle D, Katsarava Z, Diener HC, Obermann M - J Headache Pain (2014)

Bottom Line: Anodal tDCS reduced pain intensity significantly after two weeks of treatment.The attack frequency reduction was not significant.No severe adverse events were reported.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurology, University Hospital Essen, Hufelandstr, 55, 45147 Essen, Germany. mark.obermann@uni-due.de.

ABSTRACT

Background: Transcranial direct current stimulation (tDCS) of the primary motor cortex has been shown to modulate pain and trigeminal nociceptive processing.

Methods: Ten patients with classical trigeminal neuralgia (TN) were stimulated daily for 20 minutes over two weeks using anodal (1 mA) or sham tDCS over the primary motor cortex (M1) in a randomized double-blind cross-over design. Primary outcome variable was pain intensity on a verbal rating scale (VRS 0-10). VRS and attack frequency were assessed for one month before, during and after tDCS. The impact on trigeminal pain processing was assessed with pain-related evoked potentials (PREP) and the nociceptive blink reflex (nBR) following electrical stimulation on both sides of the forehead before and after tDCS.

Results: Anodal tDCS reduced pain intensity significantly after two weeks of treatment. The attack frequency reduction was not significant. PREP showed an increased N2 latency and decreased peak-to-peak amplitude after anodal tDCS. No severe adverse events were reported.

Conclusion: Anodal tDCS over two weeks ameliorates intensity of pain in TN. It may become a valuable treatment option for patients unresponsive to conventional treatment.

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Related in: MedlinePlus

Analgesic efficacy of anodal transcranial direct currents stimulation (tDCS). tDCS significantly decreases mean pain intensity on the verbal rating scale (VRS) (p < 0.05), while attack frequency (AF) is not significantly different compared to control conditions. Changes of values are expressed as Δ compared to mean values under control conditions in box plots.
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Figure 2: Analgesic efficacy of anodal transcranial direct currents stimulation (tDCS). tDCS significantly decreases mean pain intensity on the verbal rating scale (VRS) (p < 0.05), while attack frequency (AF) is not significantly different compared to control conditions. Changes of values are expressed as Δ compared to mean values under control conditions in box plots.

Mentions: Pain intensity (VRS) difference comparing anodal stimulation effect (post-stimulation minus baseline) with the sham effect (post-stimulation minus baseline) was 29% (p = 0.008; Figure 2). VRS decreased after anodal stimulation from baseline by 18% (±SD 29%, while sham stimulation led to an 11% (±30.8%) increase of VRS (Figure 2, Table 1). Attack frequency was not significantly decreased between sham or anodal stimulation (p = 0.123); Figure 1). One patient was completely pain free after anodal stimulation.


Patient-conducted anodal transcranial direct current stimulation of the motor cortex alleviates pain in trigeminal neuralgia.

Hagenacker T, Bude V, Naegel S, Holle D, Katsarava Z, Diener HC, Obermann M - J Headache Pain (2014)

Analgesic efficacy of anodal transcranial direct currents stimulation (tDCS). tDCS significantly decreases mean pain intensity on the verbal rating scale (VRS) (p < 0.05), while attack frequency (AF) is not significantly different compared to control conditions. Changes of values are expressed as Δ compared to mean values under control conditions in box plots.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4256974&req=5

Figure 2: Analgesic efficacy of anodal transcranial direct currents stimulation (tDCS). tDCS significantly decreases mean pain intensity on the verbal rating scale (VRS) (p < 0.05), while attack frequency (AF) is not significantly different compared to control conditions. Changes of values are expressed as Δ compared to mean values under control conditions in box plots.
Mentions: Pain intensity (VRS) difference comparing anodal stimulation effect (post-stimulation minus baseline) with the sham effect (post-stimulation minus baseline) was 29% (p = 0.008; Figure 2). VRS decreased after anodal stimulation from baseline by 18% (±SD 29%, while sham stimulation led to an 11% (±30.8%) increase of VRS (Figure 2, Table 1). Attack frequency was not significantly decreased between sham or anodal stimulation (p = 0.123); Figure 1). One patient was completely pain free after anodal stimulation.

Bottom Line: Anodal tDCS reduced pain intensity significantly after two weeks of treatment.The attack frequency reduction was not significant.No severe adverse events were reported.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurology, University Hospital Essen, Hufelandstr, 55, 45147 Essen, Germany. mark.obermann@uni-due.de.

ABSTRACT

Background: Transcranial direct current stimulation (tDCS) of the primary motor cortex has been shown to modulate pain and trigeminal nociceptive processing.

Methods: Ten patients with classical trigeminal neuralgia (TN) were stimulated daily for 20 minutes over two weeks using anodal (1 mA) or sham tDCS over the primary motor cortex (M1) in a randomized double-blind cross-over design. Primary outcome variable was pain intensity on a verbal rating scale (VRS 0-10). VRS and attack frequency were assessed for one month before, during and after tDCS. The impact on trigeminal pain processing was assessed with pain-related evoked potentials (PREP) and the nociceptive blink reflex (nBR) following electrical stimulation on both sides of the forehead before and after tDCS.

Results: Anodal tDCS reduced pain intensity significantly after two weeks of treatment. The attack frequency reduction was not significant. PREP showed an increased N2 latency and decreased peak-to-peak amplitude after anodal tDCS. No severe adverse events were reported.

Conclusion: Anodal tDCS over two weeks ameliorates intensity of pain in TN. It may become a valuable treatment option for patients unresponsive to conventional treatment.

Show MeSH
Related in: MedlinePlus