Disclosure : Y wish to thank the EFNS for the support of the work by an Educational fellowship (in 2010) and the research team of Institute Guttmann for sharing their experience in application of tDCS.
EFFECTIVENESS OF TRANSCRANIAL DIRECT CURENT STIMULATION IN THE TREATMENT OF CHRONIC NEUROPATHIC PAIN IN SPINAL CORD INJURY
Background and aims.
About 40-70% of patients with SCI (spinal cord injury) suffer from neuropathic pain (NP) being severe enough to impair their life quality and rehabilitation.
The aim of the study was to establish if the application of transcranial Direct Current Stimulation (tDCS) in patients with chronic NP secondary to SCI will reduce the severity of pain and associated psychological comorbidities.
Methods.
Thirty patients with chronic NP after SCI, divided in 2 groups, were included in the study. Pain and psychological comorbidities variability were measured according to the numerical rating scale (NRS). Ten sessions of 20min of tDCS (2mA) were applied over C3 or C4 areas in 15 subjects. Fifteen patients of the sham group received 30s of stimulation.
Patients were evaluated before and at last day of treatment, at 4, 8 and 12 weeks after treatment.
Results
After the last day of treatment, the NRS of overall pain intensity perception was reduced by 16,8% with respect to baseline in the tDCS group, a significant reduction compared to placebo group (P=0.03). Daily frequency of pain attacks decreased in the tDCS group after treatment in comparison to baseline (6.8±5.9 versus 3.1±2.9) (P=0.03) but not during the follow-up.
The scores for anxiety diminished after the last day of treatment in the active group (P=0.02) in comparison to baseline and was maintained up to 4 weeks (P=0.03).
Conclusion.
Our results demonstrate that tDCS can be effective in the management of chronic NP improving the life quality and rehabilitation process of SCI patients.
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