The efficacy of transcranial direct current stimulation and transcranial magnetic stimulation for chronic orofacial pain: A systematic review

Abstract

Background Transcranial Direct Current Stimulation (tDCS) and Transcranial Magnetic Stimulation (TMS) have been described as promising alternatives to treat different pain syndromes. This study evaluated the effects of TMS and tDCS in the treatment of chronic orofacial pain, through a systematic review. Methods An electronic search was performed in major databases: MEDLINE, Scopus, Web of Science, Cochrane, Embase, LILACS, BBO, Open Gray and CINAHL. The eligibility criteria comprised randomized clinical trials (RCTs) that applied TMS or tDCS to treat chronic orofacial pain. The variables analyzed were pain, functional limitation, quality of life, tolerance to treatment, somatosensory changes, and adverse effects. The risk of bias was assessed through the Cochrane Collaboration tool, and the certainty of evidence was evaluated through GRADE. The protocol was registered in the PROSPERO database (CRD42018090774). Results The electronic search resulted in 636 studies. Thereafter, the eligibility criteria were applied and the duplicates removed, resulting in eight RCTs (four TMS and four tDCS). The findings of these studies suggest that rTMS applied to the Motor cortex (M1), the dorsolateral prefrontal cortex (DLPFC) and the secondary somatosensory cortex (S2) provide adequate orofacial pain relief. Two studies reported significant pain improvement with tDCS applied over M1 while the other two failed to demonstrate significant effects compared to placebo. Conclusions rTMS, applied to M1, DLPFC or S2, is a promising approach for the treatment of chronic orofacial pain. Moreover, tDCS targeting M1 seems to be also effective in chronic orofacial pain treatment. The included studies used a wide variety of therapeutic protocols. In addition, most of them used small sample sizes, with a high risk of biases in their methodologies, thus producing a low quality of evidence. The results indicate that further research should be carried out with caution and with better-standardized therapeutic protocols.

The roles of the LpSTS and DLPFC in self‐prioritization: A transcranial magnetic stimulation study

“…First, while recent studies focused on the role of VMPFC (Martinez-Perez et al, 2020;Schafer & Frings, 2019;Yin et al, 2021) and DLPFC (Martinez-Perez et al, 2020), the current study provides novel evidence regarding the role of the LpSTS. Second, null results in previous studies might be partially attributed to the relative impreciseness of tDCS targeting while the TMS technique in the current study allows for more precise stimulation (Elder & Taylor, 2014;Ferreira et al, 2019;Kurmakaeva et al, 2021). Third, the usage of HDDM analysis allowed us to separate the effect of TMS on different processing components and indicated that the modulatory effect of LpSTS TMS was manifested in the process of information accumulation (Golubickis et al, 2017(Golubickis et al, , 2020Wiecki et al, 2013).…”

Systematic Review of the Impact of Transcranial Direct Current Stimulation on the Neuromechanical Management of Foot and Ankle Physical Performance in Healthy Adults

“…The following inclusion criteria were applied based on the Participants, Intervention, Comparison, Outcomes, and Study design (Ferreira et al, 2019 ). (1) The participants were healthy adults with no history of musculoskeletal injury and overt neurological disease.…”

Review on Effective Treatments of Burning Mouth Syndrome

“…TDCS is applied with weak electric currents at specific times [32][33][34]. A systematic review study in 2019 reported the positive effect of these two methods in reducing chronic orofacial pain [35]. In the systematic review study conducted in 2018 [36], 14 studies (3 TMS studies and 11 TDCS studies) were performed on 228 patients and the results showed that both TMS and TDCS methods are safe and effective treatments for reducing chronic orofacial pain.…”