Is transcranial direct current stimulation beneficial for treating pain, depression, and anxiety symptoms in patients with chronic pain? A systematic review and meta-analysis

Wen, Yu-Rong; Shi, Jian; Hu, Zheng-Yu; Lin, Yangyang; Lin, You-Tian; Jiang, Xue; Wang, Rui; Wang, Xueqiang; Wang, Yuling

doi:10.3389/fnmol.2022.1056966

Cited by 18 publications

(10 citation statements)

References 97 publications

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“…They included 27 randomized controlled trials with a total of 1,015 participants who received tDCS or sham stimulation for various chronic pain conditions. They found that tDCS was significantly more effective than sham stimulation in reducing short-term pain intensity (SMD = -0.43, 95% CI = -0.75 to -0.12), short-term and middle-term depression (SMD = -0.31, 95% CI = -0.47 to -0.14, and SMD = -0.35, 95% CI = -0.58 to -0.11), and anxiety scores (SMD = -0.36, 95% CI = -0.58 to -0.14) in patients with chronic pain, but longer-lasting effects were not observed [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

The effects of transcranial direct-current stimulation (tDCS) on pain intensity of patients with fibromyalgia: a systematic review and meta-analysis

Moshfeghinia,

Shekouh,

Mostafavi

et al. 2023

BMC Neurol

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Introduction Fibromyalgia (FM) is a chronic pain condition that affects millions of people worldwide. Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique that has shown promise as a potential treatment for FM by modulating pain perception and reducing symptoms, such as fatigue and depression. We aimed to systematically review studies that assess the effect of tDCS on pain reduction in FM patients. Methods Seven electronic databases (PubMed, Scopus, Embase, PsycINFO, Web of Science, Cochrane, and CINAHL Complete) were searched for records in English. Studies that measured the effect of tDCS on pain intensity in FM patients were included. The Cochrane Collaboration’s tool was used to assess the quality of the included studies. A random-effect model was preferred, and statistical analysis was performed by Stata software version 17. Results Twenty studies were included for qualitative, and eleven for quantitative analysis. Out of 664 patients included in the study, 443 were in the stimulation group. The left M1 area was the most common stimulation target (n = 12), and 2 mA was the most common stimulation amplitude (n = 19). The analysis showed that active tDCS significantly reduced pain intensity in FM patients in comparison to the sham group (SMD= -1.55; 95% CI -2.10, -0.99); also, no publication bias was noted. Conclusion Our systematic review highlights the potential effect of tDCS on the reduction of pain intensity in FM patients. Additionally, this current evidence could suggest that tDCS applied at an intensity of 2mA to the left M1 is the most effective strategy.

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Section: Discussionmentioning

confidence: 99%

The effects of transcranial direct-current stimulation (tDCS) on pain intensity of patients with fibromyalgia: a systematic review and meta-analysis

Moshfeghinia,

Shekouh,

Mostafavi

et al. 2023

BMC Neurol

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“…In patients undergoing total knee arthroplasty, tDCS of PFC, but not M1, reduced opioid use in the three-day period following surgery (Borckardt et al, 2017), which strengthens the clinical relevance of PFC stimulation as an adjunctive therapy for pharmacological treatment of surgical pain. However, discrepancies over the effectiveness of tDCS remain as systematic reviews and meta-analysis report limited evidence for a pain reducing effect of tDCS targeted to the PFC in fibromyalgia or neuropathic pain (Zhu et al, 2017;Knotkova et al, 2021;Wen et al, 2022), which means improvements are needed in this area.…”

Section: Non-invasive Brain Stimulationmentioning

confidence: 99%

Targeting PFC dysfunction in pain

Kummer,

Sheets

2024

J Pharmacol Exp Ther

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The prefrontal cortex (PFC) has justifiably become a significant focus of chronic pain research.Collectively, decades of rodent and human research have provided strong rationale for studying the dysfunction of the PFC as a contributing factor in the development and persistence of chronic pain and as a key supraspinal mechanism for pain-induced comorbidities such as anxiety, depression and cognitive decline. Chronic pain alters the structure, chemistry, and connectivity of PFC in both humans and rodents. In this review, we broadly summarize the complexities of reported changes within both rodent and human PFC caused by pain and offer insight into potential pharmacological and non-pharmacological approaches for targeting PFC to treat chronic pain and pain-associated comorbidities. SIGNIFICANCE STATEMENTChronic pain is a significant unresolved medical problem causing detrimental changes to physiological, psychological, and behavioral aspects of life. Drawbacks of currently approved pain therapeutics include incomplete efficacy and potential for abuse producing a critical need for novel approaches to treat pain and comorbid disorders. In this review, we provide insight into how manipulation of PFC circuits could address this unmet need of more efficacious and safer pain therapeutics.

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“…This suggests that patients with knee osteoarthritis may be more receptive to tDCS with additional therapy when the treatment plan is of moderate length [37,43]. A recent review supported the selective treatment effects of tDCS, demonstrating that the groups receiving 5-10 sessions of tDCS showed a significant improvement in chronic pain [44].…”

Section: Knee Painmentioning

confidence: 99%

Transcranial Direct Current Stimulation for Orthopedic Pain: A Systematic Review with Meta-Analysis

Adams,

Idnani,

Kim

2024

Brain Sciences

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(1) Background: Transcranial direct current stimulation (tDCS) appears to alleviate chronic pain via a brain-down mechanism. Although several review studies have examined the effects of tDCS on patients with chronic pain, no systematic review or meta-analysis has comprehensively analyzed the effects of tDCS on chronic orthopedic joint pain in one study. We aim to evaluate the effectiveness of tDCS for pain reduction in chronic orthopedic patients; (2) Methods: A comprehensive search of five electronic databases (Medline, Embase, Web of Science, CINAHL, and Cochrane) was performed. Only randomized controlled trials that compared tDCS with a control intervention were included. Eighteen studies met our inclusion criteria. We identified four categories of chronic orthopedic pain: knee (k = 8), lower back (k = 7), shoulder (k = 2), and orofacial pain (k = 1). Random effect models were utilized, and a sensitivity analysis was conducted in the presence of significant heterogeneity. Studies within each pain condition were further classified according to the number of treatment sessions: 1–5 sessions, 6–10 sessions, and >10 sessions.; (3) Results: Significant reductions in chronic orthopedic joint pain were observed following tDCS compared to controls for knee (g = 0.59, p = 0.005), lower back (g = 1.14, p = 0.005), and shoulder (g = 1.17, p = 0.020). Subgroup analyses showed pain reductions after 6–10 tDCS sessions for knee pain and after 1–5 and >10 sessions for lower back pain; (4) Conclusions: tDCS could be considered a potential stand-alone or supplemental therapy for chronic knee and lower back pain. The effectiveness of tDCS treatment varies depending on the number of treatment sessions. Our findings suggest the importance of implementing individualized treatment plans when considering tDCS for chronic pain conditions.

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Is transcranial direct current stimulation beneficial for treating pain, depression, and anxiety symptoms in patients with chronic pain? A systematic review and meta-analysis

Cited by 18 publications

References 97 publications

The effects of transcranial direct-current stimulation (tDCS) on pain intensity of patients with fibromyalgia: a systematic review and meta-analysis

The effects of transcranial direct-current stimulation (tDCS) on pain intensity of patients with fibromyalgia: a systematic review and meta-analysis

Targeting PFC dysfunction in pain

Transcranial Direct Current Stimulation for Orthopedic Pain: A Systematic Review with Meta-Analysis

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