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Published on: January 18, 2021
Reducing Chronic Pain With Transcranial Direct Current Stimulation in Veterans Engaged in Intensive Outpatient Mental
Sheila A M Rauch1,2,3, Carly Yasinski3, Mahsa Mojallal3
1Mental Health Service Line, Joseph Maxwell Cleland Atlanta VA Medical Center, Decatur, GA 30030, United States.
Introduction:
Pain is highly comorbid with mental health issues in Veterans and service members. This study examined the feasibility and preliminary outcomes of augmenting a 2-week intensive outpatient (IOP) mental health program for veteran military service members with transcranial direct current stimulation (tDCS) to address comorbid pain, PTSD and depressive symptoms.
Materials And Methods:
Thirty-eight participants were enrolled in an open pilot trial of up to 10 tDCS sessions (in-person or home-based at 2 mA for 20 minutes over bilateral motor cortex) for chronic pain delivered daily before individual therapy during the 2-week Emory Healthcare Accelerated Brain Health Program (ABHP). For PTSD and depression outcomes only, 38 demographically case-matched controls were compared to those who received tDCS.
Results:
Eighty-seven percent of those enrolled completed at least seven tDCS sessions. During the 2-week treatment period, pain scores as measured by the Defense and Veterans Pain Rating Scale (DVPRS) showed significant reductions in pain interference with activity, sleep, mood, and stress (P's = .008-.014), though interference increased significantly over 12 months following discontinuation of tDCS (P's = .004-.011) and returned close to baseline. PTSD and depression severity significantly improved during treatment (PTSD, B = -1.68, P < .001; depression, B = -0.58, P < .001) and was maintained over 12 months. No significant differences in mental health symptom trajectories were observed between open trial tDCS and matched controls.
Conclusions:
This pilot study shows that integrating tDCS into an IOP is feasible and is associated with short-term reductions in pain. PTSD and depression symptoms were reduced in both groups; however, the reductions among those receiving tDCS were not significantly different from those observed with psychotherapy alone. Though the impacts of tDCS faded with time, its acute association with reduced pain interference warrants further study in larger controlled trials.
Clinical Trials Registration:
ClinicalTrials.gov. Identifier: NCT-05254379.
