Transcranial direct current stimulation of the primary motor cortex on postoperative pain and spontaneous oscillatory electroencephalographic activity following lumbar spine surgery: A pilot study

Jiang, Naifu; Li, Guang-Sheng; Wei, Jinsong; Wei, Bo; Zhu, Frank; Hu, Yong

doi:10.3233/rnn-180816

Cited by 7 publications

(7 citation statements)

References 59 publications

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“…Over the last years, clinical studies targeting anodal M1 for pain control have had significant results. Different conditions have been considered as fibromyalgia [17,[48][49][50][51][52][53][54][55][56][57], neuropathic pain [58][59][60][61][62][63][64][65][66][67][68][69][70], migraine [71][72][73][74][75][76], low back pain (LBP) [77][78][79][80][81], musculoskeletal conditions [16,[82][83][84][85][86][87], myofascial pain syndrome [88,89], post-operative pain [90][91][92][93], among others (See Table 1).…”

Section: Primary Motor Cortex (M1) Tdcsmentioning

confidence: 99%

Methods and strategies of tDCS for the treatment of pain: current status and future directions

Pacheco‐Barrios¹,

Cardenas-Rojas

Thibaut

et al. 2020

Expert Review of Medical Devices

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Introduction: Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation technique which has been widely studied for the treatment of chronic pain. It is considered a promising and safe alternative pain therapy. Different targets have been tested, each having their own particular mechanisms for modulating pain perception. Areas covered:We discuss the current state of the art of tDCS to manage pain and future strategies to optimize tDCS' effects. Current strategies include primary motor cortex tDCS, prefrontal tDCS and tDCS combined with behavioral interventions while future strategies, on the other hand, include high intensity tDCS, transcutaneous Spinal Direct Current Stimulation, cerebellar tDCS, home-based tDCS and tDCS with extended number of sessions.Expert commentary: It has been shown that the stimulation of the prefrontal and primary motor cortex is efficient for pain reduction while a few other new strategies, such as high intensity tDCS and network-based tDCS, are believed to induce strong neuroplastic effects, although the underlying neural mechanisms still need to be fully uncovered. Hence, conventional tDCS approaches demonstrated promising effects to manage pain and new strategies are under development to enhance tDCS effects and make this approach more easily available by using, for instance, home-based devices.

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Section: Primary Motor Cortex (M1) Tdcsmentioning

confidence: 99%

Methods and strategies of tDCS for the treatment of pain: current status and future directions

Pacheco‐Barrios¹,

Cardenas-Rojas

Thibaut

et al. 2020

Expert Review of Medical Devices

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“…Only a few studies have investigated the effect of tDCS on acute postoperative pain. Most of these studies have reported a beneficial effect in terms of reduced pain scores and postoperative opioid use in a variety of surgical interventions such as endoscopic retrograde cholangiopancreatography (ERCP) (Borckardt et al, 2011), total knee arthroplasty (TKA) (Borckardt et al, 2013(Borckardt et al, , 2017Khedr, Sharkawy, et al, 2017), hallux valgus surgery (Ribeiro et al, 2017), spine surgery (Glaser et al, 2016;Jiang et al, 2018) and thoracotomy (Stamenkovic et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported that anodal tDCS over M1 had positive findings for pain reduction (Borckardt et al, 2013;Glaser et al, 2016;Jiang et al, 2018;Khedr, Sharkawy, et al, 2017;Ribeiro et al, 2017;Stamenkovic et al, 2020). However, few studies used tDCS-DLPFC stimulation in pain relief, most of them applied for chronic pain conditions as fibromyalgia (Fregni, Gimenes, et al, 2006) and only one study used anodal tDCS-DLPFC stimulation for postoperative pain relief after TKA (Borckardt et al, 2017) with positive findings.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, transcranial direct current stimulation (tDCS) has been proposed as a potential safe and cost‐effective treatment for the postoperative pain (Steyaert et al, 2019). Studies have suggested that dampening of the effective connectivity of the midbrain‐medial thalamic pathway using anodal tDCS can ameliorate pain and reduce the amount of opioid required for postoperative pain control (Borckardt et al, 2017; Glaser et al, 2016; Jiang et al, 2018; Khedr, Sharkawy, et al, 2017; Ribeiro et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Effects of transcranial direct current stimulation in pain and opioid consumption after spine surgery

Hamed

Khedr

Haridy

et al. 2022

European Journal of Pain

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Background Transcranial direct current stimulation (tDCS) has shown promising results in alleviating different types of pain. The present study compares the efficacy of three sessions of anodal tDCS applied over primary motor area (M1) or the left dorsolateral prefrontal cortex (DLPFC) or sham on reducing pain and the total opioid consumption in postoperative spine surgery patients. Materials Sixty‐seven out of 75 eligible patients for postoperative spine surgery were randomly allocated into one of the three experimental groups. Group A received anodal tDCS applied over M1 cortex, group B over left DLPF cortex (2 mA, 20 min) and group C received sham tDCS, all for 3 consecutive postoperative days. Patients were evaluated using a visual analogue scale (VAS) and adynamic visual analogue scale (DVAS) at baseline, and on each of the treatment days. The total morphine consumption over the 3 postoperative days was assessed. Results Two‐way repeated measures ANOVA showed no statistically significant difference in resting VAS between the three groups. However, there was significant pain improvement (P < 0.001) in DVAS in both active groups (group A and B) compared to the sham group (group C) in the postoperative period, with no significant difference between the active groups. Morphine consumption was significantly reduced in both active groups compared with the sham group, but there was no difference in consumption between the active groups. Conclusion There was a significant postoperative reduction in morphine consumption and DVAS scores after three sessions of active tDCS. Significance tDCS is a promising tool for alleviating pain in the field of postoperative spine surgery.

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“…Majority of the studies on the muscle disorder of extremities (e.g., phantom limb pain) showed good intervention effect [1,2]. Nevertheless, with respect to the muscle disorder of trunk (e.g., low back pain), no consistent conclusion had been drawn [3][4][5][6]. This was probably because that the corticospinal drive to the trunk muscles is different with that to the muscles of the extremities.…”

Section: Introductionmentioning

confidence: 99%

Mapping Responses of Lumbar Paravertebral Muscles to Single-Pulse Cortical TMS Using High-Density Surface Electromyography

Jiang

Wang

Huang

et al. 2021

IEEE Trans. Neural Syst. Rehabil. Eng.

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Motor evoked potential (MEP), which was elicited by transcranial magnetic stimulation (TMS), has been widely used to detect corticospinal projection from TMS cortical site to trunk muscles. It can help to find the stimulation hotspot in the scalp. However, it fails to precisely describe coordinated activities of trunk muscle groups with only single-channel myoelectric signal. In this study, we aimed to use high-density surface electromyography (sEMG) to explore the effect of cortical TMS on lumbar paravertebral muscles in healthy subjects. The cortical site at 1 cm anterior and 4 cm lateral to vertex was chosen to simulate using a single-pulse TMS with different intensities and forwardbending angles. A high-density electrode array (45 channels) was placed on the surface of lumbar paravertebral muscles to record sEMG signals during a TMS experiment. MEP signals elicited by TMS were extracted from 45-channel recordings and one topographic map of the MEP amplitudes with six spatial features was constructed at each sampling point. The results showed TMS could successfully evoke an oval area with high intensity in the MEP topographic map, while this area mainly located in ipsilateral side of the TMS site. Intensity features related to the high intensity area rose significantly with TMS intensity and forward-bending angle increasing, but location features showed no change. The optimal stimulation parameters were 80% of maximum stimulator output (MSO) for TMS intensity and 30/60 degree for forward-bending angle. This study provided a potentially effective mapping tool to explore the hotspot for transcranial stimulation on trunk muscles.

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Transcranial direct current stimulation of the primary motor cortex on postoperative pain and spontaneous oscillatory electroencephalographic activity following lumbar spine surgery: A pilot study

Cited by 7 publications

References 59 publications

Methods and strategies of tDCS for the treatment of pain: current status and future directions

Methods and strategies of tDCS for the treatment of pain: current status and future directions

Effects of transcranial direct current stimulation in pain and opioid consumption after spine surgery

Mapping Responses of Lumbar Paravertebral Muscles to Single-Pulse Cortical TMS Using High-Density Surface Electromyography

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