A study protocol for a single-blind, randomized controlled trial of adjunctive transcranial direct current stimulation (tDCS) for chronic pain among patients receiving specialized, inpatient multimodal pain management

Jimenez-Torres, Gladys Janice; Weinstein, Benjamin; Walker, Cory R.; Fowler, J. Christopher; Ashford, Philippa; Borckardt, Jeffrey J.; Madan, Alok

doi:10.1016/j.cct.2016.12.024

Cited by 5 publications

(2 citation statements)

References 67 publications

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“…The Houston Methodist Behavioral Health FR program was designed to address the existing barriers described in the previous section of this article. It is the latest iteration of previously developed models of care at our institution 14,42,44–47…”

Section: Functional Rehabilitationmentioning

confidence: 99%

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Functional Rehabilitation: An Integrated Treatment Model for Patients With Complex Physical and Psychiatric Conditions

Orme

Fowler

Bradshaw

et al. 2022

Journal of Psychiatric Practice

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The health care delivery system in the United States, structured to provide single-disease care, presents unique challenges for patients with complex physical and psychiatric comorbidities. Patients in these populations are often referred to multiple specialty clinics, encounter little continuity of care or collaboration among their providers, incur high health care costs, and experience poor treatment outcomes. Given these barriers, questions remain about the extent to which siloed and fragmented care, as opposed to the complex nature of the illnesses themselves, contribute to poor outcomes. If given the opportunity to receive well-integrated, consistent, and personalized care, can patients with historically difficult-to-treat comorbid medical and mental illnesses make progress? This article describes an innovative model of care called functional rehabilitation that is designed to address existing barriers in treatment. The functional rehabilitation program seeks to disrupt the escalating effects of interacting comorbidities by offering highly collaborative treatment from a small team of clinicians, personalized interventions using a shared decision-making framework, multipronged treatment options, colocation in a large hospital system, and significant 1:1 time with patients. The article includes a case example with longitudinal outcome data that illustrates how progress can be made with appropriate programmatic supports. Future research should examine the cost-effectiveness of this model of care.

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Section: Functional Rehabilitationmentioning

confidence: 99%

“…It is the latest iteration of previously developed models of care at our institution. 14,42,[44][45][46][47]…”

Section: Functional Rehabilitationmentioning

confidence: 99%

Functional Rehabilitation: An Integrated Treatment Model for Patients With Complex Physical and Psychiatric Conditions

Orme

Fowler

Bradshaw

et al. 2022

Journal of Psychiatric Practice

Self Cite

View full text Add to dashboard Cite

show abstract

Non-invasive brain stimulation techniques for chronic pain

O’Connell

Marston

Spencer

et al. 2018

Cochrane Database of Systematic Reviews

133

143

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Transcranial Direct Current Stimulation as a Therapeutic Tool for Chronic Pain

Pinto

Costa

Duarte

et al. 2018

J ECT

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Transcranial direct current stimulation (tDCS) modulates spontaneous neuronal activity that can generate long-term neuroplastic changes. It has been used in numerous therapeutic trials showing significant clinical effects especially when combined with other behavioral therapies. One area of intensive tDCS research is chronic pain. Since the initial tDCS trials for chronic pain treatment using current parameters of stimulation, more than 60 clinical trials have been published testing its effects in different pain syndromes. However, as the field moves in the direction of clinical application, several aspects need to be taken into consideration regarding tDCS effectiveness and parameters of stimulation. In this article, we reviewed the evidence of tDCS effects for the treatment of chronic pain and critically analyzed the literature pertaining its safety and efficacy, and how to optimize tDCS clinical effects in a therapeutic setting. We discuss optimization of tDCS effects in 3 different domains: (i) parameters of stimulation, (ii) combination therapies, and (iii) subject selection. This article aims to provide insights for the development of future tDCS clinical trials.

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A study protocol for a single-blind, randomized controlled trial of adjunctive transcranial direct current stimulation (tDCS) for chronic pain among patients receiving specialized, inpatient multimodal pain management

Cited by 5 publications

References 67 publications

Functional Rehabilitation: An Integrated Treatment Model for Patients With Complex Physical and Psychiatric Conditions

Functional Rehabilitation: An Integrated Treatment Model for Patients With Complex Physical and Psychiatric Conditions

Non-invasive brain stimulation techniques for chronic pain

Transcranial Direct Current Stimulation as a Therapeutic Tool for Chronic Pain

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