Randomized, Sham Controlled Trial of Transcranial Direct Current Stimulation for Painful Diabetic Polyneuropathy.
10.5535/arm.2013.37.6.766
- Author:
Yon Joon KIM
1
;
Jeonghun KU
;
Hyun Jung KIM
;
Dal Jae IM
;
Hye Sun LEE
;
Kyung Ah HAN
;
Youn Joo KANG
Author Information
1. Department of Rehabilitation Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea. md52516@hanmail.net
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Transcranial direct current stimulation;
Chronic pain;
Diabetic neuropathy
- MeSH:
Anxiety;
Chronic Pain;
Depression;
Diabetic Neuropathies*;
Electrodes;
Follow-Up Studies;
Humans;
Pain Threshold;
Prefrontal Cortex;
Visual Analog Scale
- From:Annals of Rehabilitation Medicine
2013;37(6):766-776
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the analgesic effect of transcranial direct current stimulation (tDCS) over the primary motor (M1), dorsolateral prefrontal cortex (DLPFC), and sham tDCS in patients with painful diabetic polyneuropathy (PDPN). METHODS: Patients with PDPN (n=60) were divided randomly into the three groups (n=20 per group). Each group received anodal tDCS with the anode centered over the left M1, DLPFC, or sham stimulation for 20 minutes at intensity of 2 mA for 5 consecutive days. A blinded physician rated the patients' pain using a visual analog scale (VAS), Clinical Global Impression (CGI) score, anxiety score, sleep quality, Beck Depression Inventory (BDI), and the pain threshold (PT) to pressure. RESULTS: After the tDCS sessions, the M1 group showed a significantly greater reduction in VAS for pain and PT versus the sham and DLPFC groups (p<0.001). The reduction in VAS for pain was sustained after 2 and 4 weeks of follow-up in the M1 group compared with the sham group (p<0.001, p=0.007). Significant differences were observed among the three groups over time in VAS for pain (p<0.001), CGI score (p=0.01), and PT (p<0.001). No significant difference was observed among the groups in sleep quality, anxiety score, or BDI score immediately after tDCS. CONCLUSION: Five daily sessions of tDCS over the M1 can produce immediate pain relief, and relief 2- and 4-week in duration in patients with PDPN. Our findings provide the first evidence of a beneficial effect of tDCS on PDPN.