TITLE:
Clinical Trial Demonstrates Efficacy of Transcranial Direct Current Stimulation (tDCS) in Improving Pain Management from Post-Laminectomy Syndrome
AUTHORS:
Marilia Capuço Oliveira, Fernanda Menezes de Faria, Gerardo Maria de Araújo Filho, Ana Carolina Gonçalves Olmos, Demosthenes Santana Silva Junior, Camila Souza Alves Cosmo
KEYWORDS:
Non-Invasive Neuromodulation, Transcranial Direct Current Stimulation, Post-Laminectomy Syndrome, Chronic Pain
JOURNAL NAME:
Pain Studies and Treatment,
Vol.11 No.4,
October
27,
2023
ABSTRACT: Chronic pain, a multidimensional experience affecting individuals’
sensory, cognitive, and emotional aspects, significantly impacts their quality
of life. Post-laminectomy syndrome, a condition characterized by persistent
back pain following spinal surgery, often
leads to disability and increased healthcare utilization. Methods: This
randomized, controlled, blind clinical trial aimed to investigate the efficacy
of Transcranial Direct Current Stimulation (tDCS) in managing pain from
post-laminectomy syndrome in patients. Twenty-four participants were assigned
to three groups: sham stimulation, active stimulation over primary motor cortex
(M1), or stimulation over dorsolateral prefrontal cortex (DLPFC). Stimulation
was administered for five consecutive days, 20 minutes per session, using a
current of 1.5 mA through 25 cm2 electrodes. Pain intensity was assessed using Visual Analog Scale (VAS)
before, during, and after intervention. Results: An ANOVA model demonstrates significant reduction in
pain intensity compared to baseline in VAS, (F(7, 285) = 12.292; p 0.001; Power = 1.000; η2p = 0.534),
in tDCS applied to M1, after five days of intervention. After stimulation, a
significant improvement was observed in WHOQoL-Bref Quality of life item 1 (p = 0.04),
considering statistical significant difference p 0.05.
Correlation between the variables: quality of life, depression, anxiety and pain also demonstrates
reduction in depression and anxiety according to Beck’s Depression and Anxiety
Inventories (BDI and BAI), p 0.05. This effect was not observed in DLPFC
stimulation group. Patients who believed they received active stimulation, in
sham group, demonstrated potential for effective blinding. Conclusion: The tDCS
applied to primary motor cortex effectively improved pain management and psychiatry symptoms in post-laminectomy syndrome
patients. The technique’s low cost, ease of use, and high tolerability make it
a promising adjuvant therapy for chronic pain conditions like post-laminectomy
syndrome.