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Delayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial.

Aurore Thibaut1, Sandra Carvalho2, Leslie R Morse3

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Transcranial direct current stimulation (tDCS) shows promise for managing neuropathic pain in spinal cord injury (SCI) patients. Repeated sessions are crucial for achieving long-lasting pain relief and improved quality of life.

Keywords:
Central sensitizationNeuromodulationPainSpinal cord injuryTranscranial direct current stimulationVisual analogue scale

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Area of Science:

  • Neuroscience
  • Neurology
  • Rehabilitation Medicine

Background:

  • Neuropathic pain is a significant challenge for individuals with spinal cord injury (SCI).
  • Transcranial direct current stimulation (tDCS) has shown mixed results for treating SCI pain, necessitating further investigation into its efficacy and durability.
  • Consistent and long-lasting effects are required for clinical translation of tDCS in SCI pain management.

Purpose of the Study:

  • To evaluate the direct and long-term effects of tDCS on neuropathic pain in patients with SCI.
  • To determine if repeated tDCS sessions enhance pain reduction and improve quality of life.
  • To assess the durability of tDCS effects over a 3-month follow-up period.

Main Methods:

  • A two-phase randomized sham-controlled clinical trial was conducted.
  • Phase I involved 5 days of tDCS with a 3-month follow-up; Phase II included 10 days of tDCS with an 8-week follow-up.
  • Pain levels were measured using the Visual Analogue Scale (VAS), alongside quality of life and life satisfaction assessments.

Main Results:

  • A treatment effect was observed at 1-week follow-up in Phase I and at 4-week follow-up in Phase II.
  • The active tDCS group showed significantly lower overall pain levels compared to the sham group in Phase II.
  • Exploratory findings suggest that repeated tDCS sessions are necessary for inducing long-lasting effects.

Conclusions:

  • tDCS appears to be a promising therapeutic tool for managing neuropathic pain in SCI patients.
  • Repeated stimulation sessions, potentially in multiple treatment periods, are essential for achieving durable pain relief.
  • Further research is warranted to optimize tDCS protocols for long-term SCI pain management.