EFFECTS
Anodal tDCS of M1 induced greater pain improvement compared with sham stimulation and stimulation of the DLPFC of patients with fibromyalgia. This effect was still significant after 3 weeks of follow up.

SIDE EFFECTS
The frequency of adverse effects (sleepness, itching, and headache) was not different across the three conditions of treatment.

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EFFECTS
M1 tDCS increased sleep efficiency and decreased arousals. DLPFC tDCS was associated with a decreased sleep efficiency, an increase in rapid eye movement and sleep latency. The decrease in REM latency and sleep efficiency were associated with an improvement in fibromyalgia symptoms.

SIDE EFFECTS
None reported.

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EFFECTS
Decrease in phosphine thresholds in migraine patients as in the healthy subjects after anodal stimulation; larger effect in migraine patients with aura.

SIDE EFFECTS
None reported.

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EFFECTS
Increase in perception and pain thresholds during anodal stimulation of M1; increase in pain threshold during anodal stimulation of DLPFC; no effect for occipital anodal or sham stimulation.

SIDE EFFECTS
None reported.

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EFFECTS
Pain improvement after anodal stimulation over M1 of patients with central pain due to traumatic spinal cord injury.

SIDE EFFECTS
None reported.

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EFFECTS
Decrease in perceived pain intensity and in the amplitude of N2 component under laser stimulation of the contralateral hand to the side of tDCS after cathodal stimulation.

SIDE EFFECTS
None reported.

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RISULTATI RIPORTATI NELLA LETTERATURA SCIENTIFICA

L’origine dell’effetto della tDCS nel trattamento del dolore cronico si ipotizza essere una modulazione dell’attività nelle aree cerebrali conivolte nel processo del dolore. Recenti studi hanno rilevato una riduzione del dolore nel trattemento della fibromialgia (Fregni 2006b) e del dolore cronico dovuto a danni del tessuto spinale (Fregni et al. 2006a). L’effetto analgesico sembra aver connotati di tipo accumulativo: la riduzione del dolore aumenta in seguito a ripetute sessioni di trattamento.

PROTOCOLLI USATI NELLA LETTERATURA SCIENTIFICA

La tabella seguente riassume alcuni protocolli utilizzati nella letteratura scientifica. I protocolli sono classificati e ordinati in ordine decrescente secondo il numero di soggetti sottoposti alla tDCS. Per rappresentare tale classificazione è stata utilizzata una legenda a colori.

Legenda

1 = numero di soggetti trattati = 10
11 = numero di soggetti trattati = 20
numero di soggetti trattati = 21


REFERENCE


STIMULATION ELECTRODE POSITION


REFERENCE ELECTRODE POSITION


POLARITY


ELECTRODE AREA
(cm2)


INTENSITY (mA)


CURRENT DENSITY (mA/cm2)


DURATION (min)


EFFECTS AND SIDE EFFECTS


HEALTHY SUBJECTS OR PATIENTS


NUMBER OF SUBJECTS

Fregni et al (2006 b)

M1, DLPFC

Contralateral orbit

A/S

35 cm2

2

0.057

20 min (5 days)




Patient affected by fibromyalgia

32

Roizenblatt et al. (2007)

Left M1 or DLPFC

Contralateral supraorbital area

A/S

35 cm2

2

0.057

20 min (5 days)




Patient affected by fibromyalgia

32

Chadaide et al. (2007)

occipital cortex at Oz

Cz

A/C/S

35 cm2

1

0.028

10 min (3 sessions)




16 migraine patients with and without aura;
9 healthy subjects

25

Boggio, Zaghi et al.(2008)

M1: anode over C3,
DLPFC: anode over F3,
V1:anode over Oz.

Cathode over the contralateral supraorbital area in each case.

A/S

35 cm2

2

0.057

5 min (2 sessions)




Healthy subjects

20

Fregni et al (2006 a)

M1

Contralateral orbit

A/S

35 cm2

2

0.057

20 min (5 days)




Patients with central pain after traumatic spinal cord injury

17

Antal et al. (2008)

Electrode over the left S1 (according to Talairach coordinates)

right eyebrow

A/C/S

35 cm2

1

0.028

15 min (3 sessions)




Healthy subjects

10

Chronic Pain Reference:

Antal A, Brepohl N, Poreisz C, Boros K, Csifcsak G, Paulus W. Transcranial direct current stimulation over somatosensory cortex decreases experimentally induced acute pain perception. Clinical Journal of Pain 2008; 24(1): 56–63.

Boggio PS, Zaghi S,Lopes M, Fregni F. Modulatory effects of anodal transcranial direct current stimulation on perception and pain thresholds in healthy volunteers. European Journal of Neurology 2008; 15(10): 1124–1130.

Chadaide Z, Arlt S, Antal A, Nitsche MA, Lang N, Paulus W. Transcranial direct current stimulation reveals inhibitory deficiency in migraine.Cephalalgia 2007; 27(7): 833–839.

Fregni F, Boggio PS, Lima MC, et al. A sham-controlled, phase II trial of transcranial direct current stimulation for the treatment of central pain in traumatic spinal cord injury. Pain 2006;122:197-209.(a)

Fregni F, Gimenes R, Valle AC, et al. A randomized, sham controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Arthritis Rheum 2006;54:3988-3998.(b)

O’Connell NE, Wand BM, Marston L, Spencer S, Desouza. Non-invasive brain stimulation techniques for chronic pain. A report of a Cochrane systematic review and meta-analysis. Eur J Phys Rehabil Med 2011; 47: 309-26.

Roizenblatt S, Fregni F, Gimenez R, et al. Site-specific effects of transcranial direct current stimulation on sleep and pain in fibromyalgia: a randomized, sham-controlled study. Pain Pract 2007;7: 297-306.

* Questa raccolta bibliografica include una selezione di pubblicazioni estratta da PubMed. L’inclusione di questi lavori nella presente raccolta non implica in alcun modo l’approvazione da parte di Newronika dei protocolli o dei risultati riportati in questi lavori.

** last issued: December 2015.


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