Transcranial direct current stimulation for knee osteoarthritis: a single-blind randomized sham-controlled trial

Azizi, Sirous; Rezasoltani, Zahra; Najafi, Sharif; Mohebi, Bahare; Tabatabaee, Seyed Morteza; Dadarkhah, Afsaneh

doi:10.1016/j.neucli.2020.12.002

Cited by 19 publications

(32 citation statements)

References 31 publications

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“…Full texts of 33 records were evaluated, and finally, 13 RCTs met the inclusion criteria (Figure 1). [19][20][21][22][27][28][29][30][31][32][33][34][35] The reasons for excluded trials appear in Supplementary Table 3.…”

Section: Resultsmentioning

confidence: 99%

“…Mean duration of disease was at least six months in three studies 21,29,30 and between seven and nine years in two studies. 28,31 KOA severity was reported in nine studies 19,21,22,[29][30][31][34][35][36] based on the Kellgren and Lawrence radiologic assessment scale 37 and mostly ranged from grade 2 to 3. For tDCS parameters, the current intensity was set 2 mA in nine studies [19][20][21][22]27,29,30,32,[34][35][36] and 1 mA in two studies.…”

Section: Resultsmentioning

confidence: 99%

“…28,31 KOA severity was reported in nine studies 19,21,22,[29][30][31][34][35][36] based on the Kellgren and Lawrence radiologic assessment scale 37 and mostly ranged from grade 2 to 3. For tDCS parameters, the current intensity was set 2 mA in nine studies [19][20][21][22]27,29,30,32,[34][35][36] and 1 mA in two studies. 28,31 All studies except one 30 applied stimulations for 20 minutes.…”

Section: Resultsmentioning

confidence: 99%

“…[19][20][21] On the contrary, one study found that there was no statistical significance in pain between the tDCS and sham tDCS groups. 22 Therefore, clinical data evaluating the effects of tDCS for KOA were inconsistent.…”

Section: Introductionmentioning

confidence: 99%

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Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Yang,

Li,

Wang

et al. 2024

Arthritis Care & Research

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BackgroundThe effects of transcranial direct current stimulation (tDCS) in the treatment of knee osteoarthritis (KOA) is still unclear.ObjectiveTo evaluate the efficacy and safety of tDCS in improving symptoms in patients with KOA.Data sources and study selectionThe following electronic databases were searched for eligible randomized controlled trials (RCTs): PubMed, EMBASE, Web of Science, and the Cochrane Library. The search was performed from the inception dates to April 30, 2023.Data extraction and synthesisData extraction and quality assessment were performed by 2 independent reviewers. Standard mean differences (SMDs) with 95% confidence intervals (95% CIs) for pooled data were calculated. A random‐effects model was used for the data analyses.Main outcomes and measuresThe primary outcomes were pain and physical function. Secondary outcomes included stiffness, mobility performance, quality of life, pressure pain tolerance, and plasma levels of brain‐derived neurotrophic factor (BDNF).ResultsThis meta‐analysis included 13 RCTs. tDCS was significantly associated with pain decrease compared with sham tDCS (SMD = ‐0.62, 95% CI: [‐0.87, ‐0.37], P < 0.00001). When compared tDCS plus other non‐tDCS with sham tDCS plus other non‐tDCS, there was no longer an significant association with pain decrease (SMD = ‐0.45, 95% CI: [‐1.08, 0.17], P = 0.16). The changes in physical function were not significantly different between the tDCS and sham tDCS groups. (SMD = ‐0.09, 95% CI: [‐0.56, 0.38], P = 0.71). When compared tDCS plus other non‐tDCS with sham tDCS plus other non‐tDCS, there was still no significant association with improvement in physical function (SMD = ‐0.66, 95% CI: [‐1.63, 0.30], P = 0.18). There was no significant difference with improvement in stiffness (SMD = ‐0.21, 95% CI: [‐0.77, 0.34], P = 0.45), mobility performance (SMD = 4.58, 95% CI: [‐9.21, 18.37], P = 0.51), quality of life (SMD = ‐7.01, 95% CI: [‐22.61, 8.59], P = 0.38), pressure pain tolerance (SMD = 0.30, 95% CI: [‐0.09, 0.69], P = 0.13). There was a statistically significant reduction in plasma levels of BDNF (SMD = ‐13.57, 95% CI: [‐24.23, ‐2.92], P = 0.01)ConclusionsIn conclusion, tDCS could significantly alleviate pain, but it might had no efficacy in physical function, stiffness, mobility performance, quality of life, pressure pain tolerance among KOA patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Yang,

Li,

Wang

et al. 2024

Arthritis Care & Research

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“…It is designed to act on the neuronal state to facilitate the modulation of dysfunctional excitability patterns in the brain and induce neuronal plasticity. Clinical trials have explored the analgesic effect of tDCS on knee OA [33][34][35][36][37][38] and have also demonstrated the efficacy of tDCS in reducing pain in other chronic pain conditions after the stimulation of brain regions related to pain processing [39][40][41][42][43][44][45][46][47][48][49][50][51][52]. However, although there have been positive and significant results in tDCS trials for pain management, the results are heterogeneous.…”

Section: Introductionmentioning

confidence: 99%

Development of a Clinical Prediction Rule for Treatment Success with Transcranial Direct Current Stimulation for Knee Osteoarthritis Pain: A Secondary Analysis of a Double-Blind Randomized Controlled Trial

et al. 2022

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The study’s objective was to develop a clinical prediction rule that predicts a clinically significant analgesic effect on chronic knee osteoarthritis pain after transcranial direct current stimulation treatment. This is a secondary analysis from a double-blind randomized controlled trial. Data from 51 individuals with chronic knee osteoarthritis pain and an impaired descending pain inhibitory system were used. The intervention comprised a 15-session protocol of anodal primary motor cortex transcranial direct current stimulation. Treatment success was defined by the Western Ontario and McMaster Universities’ Osteoarthritis Index pain subscale. Accuracy statistics were calculated for each potential predictor and for the final model. The final logistic regression model was statistically significant (p < 0.01) and comprised five physical and psychosocial predictor variables that together yielded a positive likelihood ratio of 14.40 (95% CI: 3.66–56.69) and an 85% (95%CI: 60–96%) post-test probability of success. This is the first clinical prediction rule proposed for transcranial direct current stimulation in patients with chronic pain. The model underscores the importance of both physical and psychosocial factors as predictors of the analgesic response to transcranial direct current stimulation treatment. Validation of the proposed clinical prediction rule should be performed in other datasets.

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Adjunctive therapies in addition to land-based exercise therapy for osteoarthritis of the hip or knee

French

Abbott

Galvin

2022

Cochrane Database of Systematic Reviews

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Transcranial direct current stimulation for knee osteoarthritis: a single-blind randomized sham-controlled trial

Cited by 19 publications

References 31 publications

Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Transcranial Direct Current Stimulation for Knee Osteoarthritis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Development of a Clinical Prediction Rule for Treatment Success with Transcranial Direct Current Stimulation for Knee Osteoarthritis Pain: A Secondary Analysis of a Double-Blind Randomized Controlled Trial

Adjunctive therapies in addition to land-based exercise therapy for osteoarthritis of the hip or knee

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