Effect of High-definition Transcranial Direct Current Stimulation on Conditioned Pain Modulation in Healthy Adults: A Crossover Randomized Controlled Trial

Wan, Ruihan; Feng, Beibei; Jiang, Xue; Xu, Yangfan; Zhang, Ziping; Liu, Ying; Wang, Yuling

doi:10.1016/j.neuroscience.2021.10.019

Cited by 9 publications

(21 citation statements)

References 51 publications

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“…This time was taken as a parameter for cold pain tolerance (CPT). Immediately after removing the hand, the pressure pain threshold was measured again at the same site as before (PPT2) [ 22 , 26 ]. The CPM response is defined as a reduction in the perceived magnitude of pain from the test stimulus when it is delivered concurrently with the conditioning stimulus [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

The Effect of Palmitoylethanolamide on Pain Intensity, Central and Peripheral Sensitization, and Pain Modulation in Healthy Volunteers—A Randomized, Double-Blinded, Placebo-Controlled Crossover Trial

et al. 2022

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Palmitoylethanolamide (PEA) is marketed as a “dietary food for special medical purposes”. Its broad-spectrum analgesic, anti-inflammatory, and neuroprotective effects make PEA an interesting substance in pain management. However, the underlying analgetic mechanisms have not yet been investigated in humans. The aim of our study is to provide a deeper understanding of the involved mechanisms, which is essential for differentiating therapeutic approaches and the establishment of mechanism-based therapeutic approaches. In this randomized, placebo-controlled, double-blinded crossover trial, 14 healthy volunteers were included. PEA (3 × 400 mg per day) or placebo were taken for 4 weeks. Our study investigated the mode of action of PEA using an established pain model, “Repetitive phasic heat application”, which is well-suited to investigate analgesic and anti-hyperalgesic effects in healthy volunteers. Parameters for peripheral and central sensitization as well as for pain modulation were assessed. Repetitive heat pain was significantly decreased, and the cold pain tolerance was significantly prolonged after the PEA treatment. The pressure pain tolerance and the conditioned pain modulation were increased after the PEA treatment. The wind-up ratio and the average distance of allodynia were significantly decreased after the PEA treatment. The heat pain tolerance was significantly higher after the PEA treatment. The present study has demonstrated that PEA has clinically relevant analgesic properties, acting on both peripheral and central mechanisms as well as in pain modulation.

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Section: Methodsmentioning

confidence: 99%

The Effect of Palmitoylethanolamide on Pain Intensity, Central and Peripheral Sensitization, and Pain Modulation in Healthy Volunteers—A Randomized, Double-Blinded, Placebo-Controlled Crossover Trial

et al. 2022

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“…Several studies have reported PPT findings in line with Study I in healthy subjects 201,208,209 . While Jürgens et al and Lerma-Lara utilized the conventional M1-tDCS montage 209 , both Wan et al 210 and Jiang et al 208 utilized HD-tDCS montages identical to the M1-tDCS montage of Study I. The overall conflicting findings make it difficult to draw conclusions on the modulatory efficacy of HD-tDCS on PPTs in healthy subjects.…”

Section: Pressure Pain Thresholdsupporting

confidence: 77%

“…This could indicate that habituation to the assessment occurred over the repeated sessions. Habituation to PPT testing following repeated assessments has been reported before and may be a result of the novelty and salience of the stimuli decreasing when repeated [199][200][201] . Alternatively, the decreased pressure sensitivity seen across groups could be a result of a placebo-effect, as the decreased pressure sensitivity was also seen in the Sham-tDCS group.…”

Section: Pressure Pain Thresholdmentioning

confidence: 71%

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Modulating the somatosensory system using high-definition transcranial direct current stimulation

Kold¹

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“…Randomization was done by a third party that prior to the experiment, had assigned the subject IDs to the four corresponding groups. The sample size was based on detecting a small to medium effect size, with 80% power and an alpha level of 0.05, and is in line with similar studies (Flood et al, 2016;Giannoni-Luza et al, 2020;Ihle et al, 2014;Jiang et al, 2022;Pinto et al, 2018;Wan et al, 2021).…”

Section: Participantsmentioning

confidence: 81%

Modulation of central pain mechanisms using high‐definition transcranial direct current stimulation: A double‐blind, sham‐controlled study

Kold

Graven‐Nielsen

2022

European Journal of Pain

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Background:The use of high-definition transcranial direct current stimulation (HD-tDCS) has shown analgesic effects in some chronic pain patients, but limited anti-nociceptive effects in healthy asymptomatic subjects. Methods: This double-blinded sham-controlled study assessed the effects of HD-tDCS applied on three consecutive days on central pain mechanisms in healthy participants with (N = 40) and without (N = 40) prolonged experimental pain induced by intramuscular injection of nerve growth factor into the right hand on Day 1. Participants were randomly assigned to Sham-tDCS (N = 20 with pain, N = 20 without) or Active-tDCS (N = 20 with pain, N = 20 without) targeting simultaneously the primary motor cortex and dorsolateral prefrontal cortex for 20 min with 2 mA stimulation intensity. Central pain mechanisms were assessed by cuff algometry on the legs measuring pressure pain sensitivity, temporal summation of pain (TSP) and conditioned pain modulation (CPM), at baseline and after HD-tDCS on Day 2 and Day 3. Based on subject's assessment of received HD-tDCS (sham or active), they were effectively blinded. Results: Compared with Sham-tDCS, Active-tDCS did not significantly reduce the average NGF-induced pain intensity. Tonic pain-induced temporal summation at Day 2 and Day 3 was significantly lower in the NGF-pain group under Active-tDCS compared to the pain group with Sham-tDCS (p ≤ 0.05). No significant differences were found in the cuff pressure pain detection/tolerance thresholds or CPM effect across the 3 days of HD-tDCS in any of the four groups. Conclusion: HD-tDCS reduced the facilitation of TSP caused by tonic pain suggesting that efficacy of HD-tDCS might depend on the presence of sensitized central pain mechanisms.

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Effect of High-definition Transcranial Direct Current Stimulation on Conditioned Pain Modulation in Healthy Adults: A Crossover Randomized Controlled Trial

Cited by 9 publications

References 51 publications

The Effect of Palmitoylethanolamide on Pain Intensity, Central and Peripheral Sensitization, and Pain Modulation in Healthy Volunteers—A Randomized, Double-Blinded, Placebo-Controlled Crossover Trial

The Effect of Palmitoylethanolamide on Pain Intensity, Central and Peripheral Sensitization, and Pain Modulation in Healthy Volunteers—A Randomized, Double-Blinded, Placebo-Controlled Crossover Trial

Modulating the somatosensory system using high-definition transcranial direct current stimulation

Modulation of central pain mechanisms using high‐definition transcranial direct current stimulation: A double‐blind, sham‐controlled study

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