Transcranial Alternating Current Stimulation at Alpha Frequency Reduces Pain When the Intensity of Pain is Uncertain

Arendsen, Laura J.; Hugh‐Jones, Siobhan; Lloyd, David T.

doi:10.1016/j.jpain.2018.02.014

Cited by 45 publications

(54 citation statements)

References 64 publications

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“…However, where this study only included brief periods of stimulation, Ahn et al applied alpha tACS for 40 minutes. In an experimental pain setting with pain-free volunteers, Ecsy et al (2018; achieved a significant reduction in pain ratings using 10 minutes of auditory and visual stimulation and Arendsen et al (2018) applied alpha tACS for 15-20 minutes. This feasibility study focused primarily on the entrainment of alpha activity, where it has been shown that even very short periods of stimulation can entrain alpha oscillations (Herrmann 2001;Mathewson et al 2012;.…”

Section: Discussionmentioning

confidence: 99%

“…Camfferman et al 2017), the functional role of alpha activity in the perception of chronic pain remains unclear. Experimental pain studies have demonstrated that the relationship between alpha activity and pain is influenced by attention (Hauck et al 2015;May et al 2012) and expectations about pain (Huneke et al 2013;Arendsen, Hugh-Jones, and Lloyd 2018), and that pain expectations can influence the effect of neuro-stimulation on pain perception (Arendsen, Hugh-Jones, and Lloyd 2018). However, the relationship between attention, expectation, and alpha activity in a setting of chronic pain is little understood.…”

Section: Discussionmentioning

confidence: 99%

“…Alpha entrainment has been successfully implemented to reduce experimentally induced pain using rhythmic visual (Ecsy, Brown, and Jones 2018), auditory (Ecsy, Jones, and Brown 2017), and transcranial alternating current stimulation (tACS) (Arendsen, Hugh-Jones, and Lloyd 2018). However, to date, only one study successfully induced an increase in somatosensory alpha power that was correlated with a reduction in pain intensity in patients with chronic low-back pain (CLBP), using tACS at alpha frequency over somatosensory regions (Ahn et al 2019).…”

Section: Introductionmentioning

confidence: 99%

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Entraining alpha activity using visual stimulation in patients with chronic musculoskeletal pain. A feasibility study

Arendsen

Henshaw

Brown

et al. 2020

Preprint

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Entraining alpha activity with rhythmic visual, auditory, and electrical stimulation can reduce experimentally induced pain. However, evidence for alpha entrainment and pain reduction in patients with chronic pain is limited. This feasibility study investigated whether visual alpha stimulation can increase alpha power in patients with chronic musculoskeletal pain and secondarily, if chronic pain was reduced following stimulation. In a within-subject design, 22 patients underwent 4-minute periods of stimulation at 10 Hz (alpha), 7 Hz (high-theta, control), and 1 Hz (control) in a pseudorandomized order. Patients underwent stimulation both sitting and standing and verbally rated their pain before and after each stimulation block on a 0-10 numerical rating scale. Global alpha power was significantly higher during 10 Hz compared to 1 Hz stimulation when patients were standing (t = -6.08, p <.001). On a more regional level, a significant increase of alpha power was found in the right-middle and left-posterior region when patients were sitting. With respect to our secondary aim, no significant reduction of pain intensity and unpleasantness was found. However, only the alpha stimulation resulted in a minimal clinically important difference in at least 50% of participants for pain intensity (50%) and unpleasantness ratings (65%) in the sitting condition. This study provides initial evidence for the potential of visual stimulation as a means to enhance alpha activity in patients with chronic musculoskeletal pain. The brief period of stimulation was insufficient to reduce chronic pain. This study is the first to provide evidence that a brief period of visual stimulation at alpha Visual alpha stimulation to reduce chronic pain 2 frequency can significantly increase alpha power in patients with chronic musculoskeletal pain. Further study is warranted to investigate optimal dose and individual stimulation parameters to achieve pain relief in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Entraining alpha activity using visual stimulation in patients with chronic musculoskeletal pain. A feasibility study

Arendsen

Henshaw

Brown

et al. 2020

Preprint

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“…Effects of tACS on other sensory modalities, including audition [5] and pain [14], have been reported. Most relevant here, however, is how tACS stimulation may influence somatosensation.…”

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confidence: 99%

Transcranial alternating current stimulation at 10 Hz modulates response bias in the Somatic Signal Detection Task

Craddock

Klepousniotou

El‐Deredy

et al. 2018

Preprint

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13Background: Ongoing, pre-stimulus oscillatory activity in the 8-13 Hz alpha range has been 14 shown to correlate with both true and false reports of peri-threshold somatosensory stimuli. 15 However, to directly test the role of such oscillatory activity in behaviour, it is necessary to 16 manipulate it. Transcranial alternating current stimulation (tACS) offers a method of 17 directly manipulating oscillatory brain activity using a sinusoidal current passed to the scalp. 18Objective: We tested whether alpha tACS would change somatosensory sensitivity or 19 response bias in a signal detection task in order to test whether alpha oscillations have a 20 causal role in behaviour. 21Methods: Active 10 Hz tACS or sham stimulation was applied using electrodes placed 22 bilaterally at positions CP3 and CP4 of the 10-20 electrode placement system. Participants 23 performed the Somatic Signal Detection Task (SSDT), in which they must detect brief 24 somatosensory targets delivered at their detection threshold. These targets are sometimes 25 accompanied by a light flash, which could also occur alone. 26Results: Active tACS did not modulate sensitivity to targets but did modulate 27 response criterion. Specifically, we found that active stimulation generally increased touch 28 reporting rates, but particularly increased responding on light trials. Stimulation did not 29 interact with the presence of touch, and thus increased both hits and false alarms. 30 Conclusions: tACS stimulation increased reports of touch in a manner consistent with 31 our observational reports, changing response bias, and consistent with a role for alpha 32 activity in somatosensory detection. 33 Keywords: somatosensation, alpha oscillations, transcranial alternating current 34 stimulation, signal detection theory 35 Word count: 3928 36 ALPHA TACS AND SOMATOSENSATION 3 Transcranial alternating current stimulation at 10 Hz modulates response bias in the 37 Somatic Signal Detection Task 38 There is a wide range of evidence across multiple sensory modalities that spontaneous, 39 ongoing neural oscillations in the alpha band -8-13 Hz -have a direct role in perception and 40 determining which stimuli are detected and which missed [1-5]. Much of this evidence is 41 necessarily correlative, based on observations recorded using magneto-or 42 electroencephalography (M/EEG). More direct evidence of causation requires direct 43 manipulation of the ongoing oscillatory rhythms naturally and spontaneously exhibited by 44 the brain.45 Transcranial electrical stimulation (tES) offers one such method of directly influencing 46 ongoing brain activity [6]. Three commonly used tES methods are transcranial direct current 47 stimulation (tDCS), transcranial alternating current stimulation [7], and transcranial random 48 noise stimulation (tRNS). Of these, tACS is particularly promising as a method by which to 49 interact with endogenous rhythms, since it allows application of a sinusoidal current at a 50 desired frequency. Indeed, there are several reports that t...

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“…Nonetheless, the current findings invite more robust and comprehensive research on the role of EEG alpha rhythm during bodily threatening events. Such note of caution is particularly relevant in light of the recent suggestion to manipulate alpha oscillations through non-invasive brain stimulation (Arendsen, Hugh-Jones, & Lloyd, 2018;Hohn, May, & Ploner, 2019) or sensory entrainment (Ecsy, Brown, & Jones, 2018).…”

Section: Discussionmentioning

confidence: 99%

Assessing the specificity of the relationship between brain alpha oscillations and tonic pain

Valentini

Halder

McInnersey

et al. 2019

Preprint

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Recent research has pointed to alpha brain oscillations as a potential clinical biomarker for sensitivity to pain. In particular, researchers claimed that the slowing of individual alpha frequency (IAF) could be an objective marker of pain during prolonged nociceptive stimulation. However, prolonged pain has been also associated with increased IAF. To date, there is insufficient evidence to conclude that IAF can be a neural marker of pain.The current study aimed at elucidating the conflicting findings by assessing the specificity of the relationship between brain alpha oscillations and tonic pain. We recorded electroencephalography (EEG) on healthy volunteers during exposure to consecutive 5minute sessions of painful hot water immersion, innocuous warm water immersion and an aversive, non-painful auditory stimulus, matched by unpleasantness to the painful condition. Participants rated stimulus unpleasantness throughout each condition. We also asked participants to sit still with eyes closed and eyes open right before and after the three experimental conditions in order to obtain a robust estimate of baseline alpha. Our findings revealed both increased and decreased IAF during tonic hot stimulation depending on the alpha range targeted (7-13 Hz vs. 8-10 Hz). In addition, they provide mild evidence for a negative relationship between IAF and the unpleasantness of the experience. Finally, we could not identify a difference between IAF during tonic hot temperature and during tonic auditory experience. Altogether, these findings emphasize a twofold frequency pattern (increase vs. decrease) for IAF during tonic thermal pain, thus indicating the need for robust methodological scrutiny of IAF as a neural marker of pain.

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Transcranial Alternating Current Stimulation at Alpha Frequency Reduces Pain When the Intensity of Pain is Uncertain

Cited by 45 publications

References 64 publications

Entraining alpha activity using visual stimulation in patients with chronic musculoskeletal pain. A feasibility study

Entraining alpha activity using visual stimulation in patients with chronic musculoskeletal pain. A feasibility study

Transcranial alternating current stimulation at 10 Hz modulates response bias in the Somatic Signal Detection Task

Assessing the specificity of the relationship between brain alpha oscillations and tonic pain

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