The Journal of Headache and Pain · 2014 · 118 citations · 33 references
MedicineNeurologyNeurosciencePain ManagementPain MedicinePain ScienceMotor Cortex StimulationNociceptive PainPain AssessmentPain NeurosciencePain ProcessingTrigeminal NeuralgiaBlink Reflex ResponsesElectrical StimulationPain Intensity Rating ScalesTrigeminal Nerve PainTrigeminal Nerve StimulationTrigeminal Nociceptive ProcessingTrigeminal Pain ModulationTrigeminal Pain Neurophysiology
BACKGROUND: Transcranial direct current stimulation (tDCS) of the primary motor cortex has been shown to modulate pain and trigeminal nociceptive processing. METHODS: Ten patients with classical trigeminal neuralgia (TN) were stimulated daily for 20 minutes over two weeks using anodal (1 mA) or sham tDCS over the primary motor cortex (M1) in a randomized double-blind cross-over design. Primary outcome variable was pain intensity on a verbal rating scale (VRS 0-10). VRS and attack frequency were assessed for one month before, during and after tDCS. The impact on trigeminal pain processing was assessed with pain-related evoked potentials (PREP) and the nociceptive blink reflex (nBR) following electrical stimulation on both sides of the forehead before and after tDCS. RESULTS: Anodal tDCS reduced pain intensity significantly after two weeks of treatment. The attack frequency reduction was not significant. PREP showed an increased N2 latency and decreased peak-to-peak amplitude after anodal tDCS. No severe adverse events were reported. CONCLUSION: Anodal tDCS over two weeks ameliorates intensity of pain in TN. It may become a valuable treatment option for patients unresponsive to conventional treatment.
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Lynn J. Bindman, O. C. J. Lippold, J. W. T. Redfearn · The Journal of Physiology · 1964 · 982 citations