I thought that this week I would include a bit about the device my Dr was using in his office and a few studies on how tDCS is affecting fibromyalgia.
The tDCS machine my Dr uses in the research study treatments from Soterix Medical PainX™ and they give these links to the research on their website for physicians to review. However they are also interesting for the information they provide patients with chronic conditions.
Soterix Medical PainX™ is a non-invasive medical device developed by physicians and researchers in NYC, as an adjunctive treatment for fibromyalgia and migraine. PainX™ is designed to provide safe and effective transcranial direct current stimulation (tDCS) without the risks or complications of surgery. Clinical trials to date have demonstrated a robust effect of tDCS on patients with difficult-to-treat cases.
Fibromyalgia
Clinically Effective Treatment of Fibromyalgia Pain With High-Definition Transcranial Direct Current Stimulation: Phase II Open-Label Dose Optimization. By Castillo-Saavedra L., Gebodh N., Bikson M., Diaz-Cruz C., Brandao R., Coutinho L., Truong D., Datta A., Shani-Hershkovich R., Weiss M., Laufer I., Reches A., Peremen Z., Geva A., Parra L.C., Fregni F. (2015)
This study showed that 50% of their patients had a reduction in their pain levels, by just 6 weeks. And, the majority of patients were showing a significant lowering of pain levels by 15 treatments.
Transcranial direct current stimulation as a treatment for patients with fibromyalgia: a randomized controlled trial. Fagerlund A.J., Hansen O.A., Aslaksen P.M. (2015)
They used, "5 consecutive 20-minute sessions of 2-mA anodal tDCS directed to the M1 in 48 patients (45 females) with fibromyalgia" and found, " that tDCS has the potential to induce statistically significant pain relief in patients with fibromyalgia, with no serious adverse effects, but small effect sizes indicate that the results are unlikely to reflect clinically important changes."
Focal modulation of the primary motor cortex in fibromyalgia using 4×1-ring high-definition transcranial direct current stimulation (HD-tDCS): immediate and delayed analgesic effects of cathodal and anodal stimulation. Villamar M.F., Wivatvongvana P., Patumanond J., Bikson M., Truong D.Q., Datta A., Fregni F. (2013)
In this study, they used had 18 patients that had 20-minute sessions at 2.0 mA, "this study examined the effects of a novel, more focal method of transcranial direct current stimulation (tDCS), using the 4×1-ring configuration of high-definition (HD)-tDCS". And that, "the center electrode was positioned over the left primary motor cortex." which is also a different way of doing it from other studies and their results were that they found that this type of tDCS also, "provides significant reduction in overall perceived pain in fibromyalgia patients".
Efficacy of anodal transcranial direct current stimulation (tDCS) for the treatment of fibromyalgia: results of a randomized, sham-controlled longitudinal clinical trial. Valle A., Roizenblatt S., Botte S., Zaghi S., Riberto M., Tufik S., Boggio P.S., Fregni F. (2009)
A very interesting study that compared which was better "Here we sought to determine whether a longer treatment protocol involving 10 sessions of 2 mA, 20 min tDCS of the left primary motor (M1) or dorsolateral prefrontal cortex (DLPFC) could offer additional, more long-lasting clinical benefits in the management of pain from fibromyalgia." The results found that the duration of the treatment was very important even suggesting, "that 10 daily sessions of tDCS result in more long lasting outcomes than only five sessions."
A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Fregni F., Gimenes R., Valle A.C., Ferreira M.J., Rocha R.R., Natalle L., Bravo R., Rigonatti S.P., Freedman S.D., Nitsche M.A., Pascual-Leone A., Boggio P.S. (2006)
One of the more interesting things I found about this study was how they described fibromyalgia as a "disorder characterized by dysfunctional brain activity." based on what recent evidence suggests. Personally I believe that's why tDCS works so well in turning down the hypersensitivity. However, reading that made me want to know what recent evidence they were speaking of. The disappointing thing about this study was that while, "Anodal tDCS of the primary motor cortex induced significantly greater pain improvement," their pain relief didn't last as they noted that, "this effect decreased after treatment ended".
For more links see below:
Migraine
State-of-art neuroanatomical target analysis of high-definition and conventional tDCS montages used for migraine and pain control. DaSilva A.F., Truong D.Q., DosSantos M.F., Toback R.L., Datta A., Bikson M. (2015)
Prophylactic treatment in menstrual migraine: A proof-of-concept study. Wickmann F., Stephani C., Czesnik D., Klinker F., Timäus C., Chaieb L., Paulus W., Antal A. (2015)
Transcranial direct current stimulation in the prophylactic treatment of migraine based on interictal visual cortex excitability abnormalities: A pilot randomized controlled trial. Rocha S., Melo L., Boudoux C., Foerster Á., Araújo D., Monte-Silva K. (2014)
Clinical effectiveness of primary and secondary headache treatment by transcranial direct current stimulation. Pinchuk D., Pinchuk O., Sirbiladze K., Shugar O. (2013)
tDCS-induced analgesia and electrical fields in pain-related neural networks in chronic migraine. Dasilva A.F., Mendonca M.E., Zaghi S., Lopes M., Dossantos M.F., Spierings E.L., Bajwa Z., Datta A., Bikson M., Fregni F. (2012)
Migraine prophylaxis by anodal transcranial direct current stimulation, a randomized, placebo-controlled trial. Auvichayapat P., Janyacharoen T., Rotenberg A., Tiamkao S., Krisanaprakornkit T., Sinawat S., Punjaruk W., Thinkhamrop B., Auvichayapat N. (2012)
Other Pain
Reduction of chronic abdominal pain in patients with inflammatory bowel disease via transcranial direct current stimulation: a randomized controlled trial. Volz M.S., Farmer A., Siegmund B. (2015)
Pain reduction associated with improved functional interhemispheric balance following transcranial direct current stimulation for post-stroke central pain: A case study. Morishita T., Hyakutake K., Saita K., Takahara M., Shiota E., Inoue T. (2015)
Effectiveness of transcranial direct current stimulation for the management of neuropathic pain after spinal cord injury: a meta-analysis. Mehta S., McIntyre A., Guy S., Teasell R.W., Loh E. (2015)
Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised-controlled trial. Oliveira L.B., Lopes T.S., Soares C., Maluf R., Goes B.T., Sá K.N., Baptista A.F. (2015)
Analgesic effect of transcranial direct current stimulation on central post-stroke pain. Bae S.H., Kim G.D., Kim K.Y. (2014)
Randomized, sham controlled trial of transcranial direct current stimulation for painful diabetic polyneuropathy. Kim Y.J., Ku J., Kim H.J., Im D.J., Lee H.S., Han K.A., Kang Y.J. (2013)
Postoperative analgesic effect of transcranial direct current stimulation in lumbar spine surgery: a randomized control trial. Dubois P.E., Ossemann M., de Fays K., De Bue P., Gourdin M., Jamart J., Vandermeeren Y. (2013)
Transcranial direct current stimulation (tDCS) reduces postsurgical opioid consumption in total knee arthroplasty (TKA). Borckardt J.J., Reeves S.T., Robinson S.M., May J.T., Epperson T.I., Gunselman R.J., Schutte H.D., Demos H.A., Madan A., Fredrich S., George M.S. (2013)
Effects of anodal transcranial direct current stimulation on chronic neuropathic pain in patients with multiple sclerosis. Mori F., Codecà C., Kusayanagi H., Monteleone F., Buttari F., Fiore S., Bernardi G., Koch G., Centonze D. (2009)
A sham-controlled, phase II trial of transcranial direct current stimulation for the treatment of central pain in traumatic spinal cord injury. Fregni F., Boggio P.S., Lima M.C., Ferreira M.J., Wagner T., Rigonatti S.P., Castro A.W., Souza D.R., Riberto M., Freedman S.D., Nitsche M.A., Pascual-Leone A. (2006)
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