Editor’s Note: We at the National Pain Report would like to hear your comments and learn about your experiences with tDCS.
Clinical studies investigating the use of transcranial direct current stimulation (tDCS) have increased steadily in recent years, with several focused on reducing fibromyalgia pain. Maybe you’ve heard of it, or maybe you haven’t. We thought we’d tell you about it and ask if you have experience with tDCS,
What is tDCS and how does it work?
tDCS is a form of neuromodulation which uses constant, low electrical current delivered to the part of the scalp that is associated with a targeted part of the brain. When stimulation is delivered through the skin, it induces intracerebral current flow that can increase or decrease neural excitability, which in turn leads to a therapeutic alteration in brain function.
What is tDCS used for?
tDCS was first developed for people with brain injuries or strokes. It’s been studied for the alleviation of depression, Parkinson’s, Alzheimer’s, pain and with healthy subjects for increased cognitive ability.
Do studies support claims that tDCS improves pain levels for people with fibromyalgia?
Studies using tDCS for fibromyalgia have been shown to improve pain levels.
A systemic review of 9 published studies were conducted in 2013 and published in Pain Practice. The authors concluded, “Studies involving excitatory rTMS/tDCS at M1 showed analogous pain reductions as well as considerably fewer side effects compared to FDA approved FMS pharmaceuticals.” That’s a pretty strong claim, and one reason we would like to hear about personal experiences with tDCS.
A 2015 study published in Arthritis Rheumatology concluded that “GABA, Glx, and NAA play an important role in the pathophysiology of fibromyalgia and its modulation by tDCS.”
Another study published in Pain Practitioner concluded that “one possible mechanism to explain the therapeutic effects of tDCS in fibromyalgia is via sleep modulation that is specific to modulation of primary M1 activity.”
A new study, which was just released by The Journal Pain this month is looking at “high definition tDCS” and the clinical “dosing” of electrical current for people with fibromyalgia.
“Despite promising preliminary results in treating fibromyalgia (FM) pain, no neuromodulation technique has been adopted in clinical practice due to limited efficacy, low response rate, or poor tolerability,” the authors wrote.
“High-Definition transcranial Direct Current Stimulation (HD-tDCS) provides targeted sub-threshold brain stimulation, combining tolerability with specificity. We aimed to establish the number of HD-tDCS sessions required to achieve a 50% FM pain reduction, and to characterize biometrics of response including Brain Network Activation (BNA) pain scores of contact heat evoked potentials (CHEPs), among others.
We report a clinically significant benefit of a 50% pain reduction in half (n=7) of subjects (n=14), with responders and non-responders alike benefiting from a cumulative effect of treatment, reflected in significant pain reduction (p=0.035) as well as improved quality of life (p=0.001) over time.
We also report an aggregate 6-week response rate of 50% of subjects, and estimate 15 as the median number of HD-tDCS sessions to reach clinically meaningful outcomes.
Methodology for a pivotal FM neuromodulation clinical trial with individualized treatment is thus supported.”
The exact reasons tDCS reduces pain are not fully understood, but researchers seem to believe that it stimulates a release of the inhibitory neurotransmitter GABA. And, certainly, different people respond to tDCS therapy differently.
If you’d like to learn a little more about tDCS you might find this article in The New Yorker, or this from PBS, interesting (NOTE: They are not related specifically to fibromyalgia or pain, just to tDCS therapy.)
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