Primary Motor Cortex Transcranial Direct Current Stimulation Modulates Temporal Summation of the Nociceptive Withdrawal Reflex in Healthy Subjects

Hughes, Sam; Grimsey, Sybil; Strutton, Paul H.

doi:10.1093/pm/pny200

Cited by 19 publications

(32 citation statements)

References 58 publications

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“…Additionally, conventional M1-tDCS failed to modulate CPM and TS in healthy subjects. These results contrast with the findings of previous studies [9][10][11][12]16,26,60].…”

Section: Discussioncontrasting

confidence: 99%

“…The main objective of the present study was to evaluate the effect of UHCDS-tDCS of M1 and DLPFC, compared to M1 stimulation alone, on the endogenous pain inhibitory system [9], and on TS in response to repeated noxious stimuli [26]. The secondary objective was to evaluate the effect of UHCDS-tDCS on pressure pain threshold and tolerance, cold pain, a neural mechanosensitivity test and isometric grip strength.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Unihemispheric Concurrent Dual-Site Stimulation over M1 and Dorsolateral Prefrontal Cortex Stimulation on Pain Processing: A Triple Blind Cross-Over Control Trial

et al. 2021

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Background: Transcranial direct current stimulation (tDCS) of the motor cortex (M1) produces short-term inhibition of pain. Unihemispheric concurrent dual-site tDCS (UHCDS-tDCS) over the M1 and dorsolateral prefrontal cortex (DLPFC) has greater effects on cortical excitability than when applied alone, although its effect on pain is unknown. The aim of this study was to test if anodal UHCDS-tDCS over the M1 and DLPFC in healthy participants could potentiate conditioned pain modulation (CPM) and diminish pain temporal summation (TS). Methods: Thirty participants were randomized to receive a sequence of UHCDS-tDCS, M1-tDCS and sham-tDCS. A 20 min 0.1 mA/cm2 anodal or sham-tDCS intervention was applied to each participant during three test sessions, according to a triple-blind cross-over trial design. For the assessment of pain processing before and after tDCS intervention, the following tests were performed: tourniquet conditioned pain modulation (CPM), pressure pain temporal summation (TS), pressure pain thresholds (PPTs), pressure pain tolerance, mechanosensitivity and cold hyperalgesia. Motor function before and after tDCS intervention was assessed with a dynamometer to measure maximal isometric grip strength. Results: No statistically significant differences were found between groups for CPM, pressure pain TS, PPT, pressure pain tolerance, neural mechanosensitivity, cold hyperalgesia or grip strength (p > 0.05). Conclusions: Neither UHCDS-tDCS nor M1-tDCS facilitated CPM or inhibited TS in healthy subjects following one intervention session.

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“…Additionally, conventional M1-tDCS failed to modulate CPM and TS in healthy subjects. These results contrast with the findings of previous studies [9][10][11][12]16,26,60].…”

Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of Unihemispheric Concurrent Dual-Site Stimulation over M1 and Dorsolateral Prefrontal Cortex Stimulation on Pain Processing: A Triple Blind Cross-Over Control Trial

et al. 2021

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“…Similar observations have been reported following rTMS of the primary motor cortex, which suggests that non‐invasive brain stimulation techniques have no effect over normal physiological nociceptive transmission (Bradley, Perchet, Lelekov‐Boissard, Magnin, & Garcia‐Larrea, 2016). Attempts to explore the discrepancies between healthy volunteers and chronic pain patients have led to a number of studies from our laboratory which have shown that temporal summation, which is associated with the generation of spinal cord excitability, is required in order for an analgesic effect to be measured following M1‐tDCS (Hughes, Ali, et al, 2018; Hughes, Grimsey, et al, 2018). We have extended these findings to show a beneficial analgesic effect over a spinally mediated sensitized pain state associated with the development of secondary mechanical hyperalgesia.…”

Section: Discussionmentioning

confidence: 99%

“…Transcranial direct current stimulation was delivered by a battery‐driven stimulator (HDCkit; Magstim) connected to a pair of electrodes (5 × 5 cm 2 ) placed within saline‐soaked sponges which were fixed in place using a cap. The anode was placed over the right M1, contralateral to the side receiving pain testing (left leg) and the cathode was placed over the contralateral (left) supraorbital cortex (Hughes, Ali, et al, 2018; Hughes, Grimsey, et al, 2018; Ngernyam, Jensen, Auvichayapat, Punjaruk, & Auvichayapat, 2013; Nitsche & Paulus, 2000). A 10‐s current ramp‐up time was used to reach a 2 mA intensity which was applied for 20 min, followed by a 10 s current fade‐out period which is in line with current safety guidelines (Poreisz, Boros, Antal, & Paulus, 2007; Woods et al, 2016).…”

Section: Methodsmentioning

confidence: 99%

Anodal transcranial direct current stimulation over the primary motor cortex attenuates capsaicin‐induced dynamic mechanical allodynia and mechanical pain sensitivity in humans

Hughes

Ward

Strutton

2020

European Journal of Pain

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Background Anodal transcranial direct current stimulation over the primary cortex has been shown to activate regions of the brain involved in the descending modulation of pain sensitivity. However, more research is required to dissect the spinal cord analgesic mechanisms associated with the development of central sensitization. Methods In this randomized, double blind, crossover study 12 healthy participants had baseline mechanical stimulus response (S/R) functions measured before and after the development of capsaicin‐induced ongoing pain sensitivity. The effects of 20 min of either real or sham transcranial direct current stimulation (tDCS, 2 mA) over the primary motor cortex on dynamic mechanical allodynia (DMA) and mechanical pain sensitivity (MPS) were then investigated. Results Topical application of capsaicin resulted in an increase in area under the pain ratings curve for both DMA (p < .01) and MPS (p < .01). The effects of tDCS on the area under the curve ratio (i.e. post‐/pre‐treatment) revealed significant analgesic effects over DMA (p < .05) and MPS (p < .05) when compared with sham. Conclusions This study demonstrates that anodal tDCS over the primary motor cortex can reduce both dynamic and static forms of mechanical pain sensitivity associated with the development of DMA and MPS, respectively. The use of tDCS may provide a novel mechanism‐driven therapy in chronic pain patients with altered mechanical S/R functions. Significance This research shows new evidence that anodal tDCS over the primary motor cortex can reduce dynamic and static forms of mechanical pain sensitivity in the capsaicin model of ongoing pain. By using this approach, it may be possible to provide mechanism‐driven analgesia in chronic pain patients who have dynamic mechanical allodynia and/or secondary mechanical hyperalgesia.

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“…DCS techniques are used in several conditions to relieve pain such as fibromyalgia 3 , spinal cord injury 4 , migraine 5 , and chronic low back pain 6 . In studies published to date, DCS has been applied over transcranial level, with the aim of modulating excitability at cortical areas such as the primary motor cortex 7 or the dorsolateral prefrontal cortex 8 , and subcortical areas such as the cerebellum 9 , and spinal cord 10 . It has been observed that could exist different mechanisms of action that depends on application modality, current parameters, and location of the DCS 11,12 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Direct Current Stimulation on Experimental Sensory Modalities and Pain Outcome Measures in Healthy Participants: Systematic Review and Meta-Analysis.

García-Barajas¹,

Taylor²,

Romero³

et al. 2020

Preprint

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Background: Objectives. The objective of this study was to compare the efficacy of direct current stimulation (DCS) applied at the transcranial, suboccipital and spinal level on experimental sensory modalities and pain outcome measures in healthy subjects. The hypothesis of this study was that systematic analysis of the efficacy of DCS on modulating evoked thermal and mechanical pain modalities and mechanisms such as endogenous pain modulation in healthy individuals would reveal sensitive outcome measures help develop this technique for the control of chronic pain. Materials and Methods. Database searches were conducted up to December 2019 for randomized controlled trials that performed sham-controlled DCS of experimental sensory modalities and pain outcomes following transcranial, suboccipital and spinal locations in healthy participants. Standardized mean differences with 95% confidence intervals were calculated for sensory modalities, including random-effect metanalysis. Results: Thirty-one studies were included for analysis (647 participants). A significant decrease in pain intensity for active vs sham transcranial stimulation was identified for pain intensity (n=158; SMD=0.79; 95% CI=0.56 to 1.02), a significant increase in heat pain threshold (n=222; SMD=1.16; 95% CI=0.95 to 1.37), and a significant increase in cold pain threshold (n = 155; SMD = 0.77, 95% CI 0.53 to 1.01). No significant modulation of pressure pain threshold was identified with DCS and only a limited number of studies focused on experimental pain modulation following neuromodulation at the suboccipital or spinal level. Conclusions: These results show significant transcranial DCS neuromodulation of pain intensity and on thermal pain modalities. Future studies should focus on endogenous pain and sensory modality modulation with sham-controlled DCS applied at transcranial, suboccipital and spinal locations.

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Primary Motor Cortex Transcranial Direct Current Stimulation Modulates Temporal Summation of the Nociceptive Withdrawal Reflex in Healthy Subjects

Cited by 19 publications

References 58 publications

Effectiveness of Unihemispheric Concurrent Dual-Site Stimulation over M1 and Dorsolateral Prefrontal Cortex Stimulation on Pain Processing: A Triple Blind Cross-Over Control Trial

Effectiveness of Unihemispheric Concurrent Dual-Site Stimulation over M1 and Dorsolateral Prefrontal Cortex Stimulation on Pain Processing: A Triple Blind Cross-Over Control Trial

Anodal transcranial direct current stimulation over the primary motor cortex attenuates capsaicin‐induced dynamic mechanical allodynia and mechanical pain sensitivity in humans

Efficacy of Direct Current Stimulation on Experimental Sensory Modalities and Pain Outcome Measures in Healthy Participants: Systematic Review and Meta-Analysis.

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