Paired Acute Invasive/Non-invasive Stimulation (PAINS) study: A phase I/II randomized, sham-controlled crossover...

Area of Science:

• Neurology
• Pain Management
• Neuroscience

Background:

• Dorsal root ganglion stimulation (DRGS) and transcranial direct current stimulation (tDCS) are established neuromodulation techniques for chronic pain relief.
• DRGS is invasive, while tDCS is non-invasive, offering different therapeutic modalities.

Purpose of the Study:

• To investigate the additive therapeutic effect of single-session tDCS combined with DRG stimulation (DRGS) for chronic pain.
• To assess the safety and efficacy of this paired invasive/non-invasive neuromodulation strategy.

Main Methods:

• A randomized, sham-controlled crossover study design was employed.
• Sixteen neuropathic pain patients with DRG stimulators participated.
• Pain scores were recorded with DRGS-OFF, DRGS-ON, DRGS-ON/sham tDCS, and DRGS-ON/active tDCS.

Main Results:

• Paired DRGS and active tDCS significantly reduced pain scores compared to DRGS alone or with sham tDCS.
• No significant adverse effects were reported, indicating tolerability.
• Significant augmentation of beta activity was observed with combined stimulation.

Conclusions:

• Single-session tDCS combined with DRGS is safe and acutely reduces pain in neuropathic pain patients.
• Paired invasive/non-invasive neuromodulation presents a promising strategy for pain management.
• Further research is warranted to evaluate the long-term benefits of this combined approach.