Abstract
Aims and Objective
Central sensitization amplifies the neural signaling within the CNS and elicits pain hypersensitivity in chronic pain. It predicts poor treatment outcomes. Facilitation (anodal tDCS) of primary motor (M1) and/or dorsolateral prefrontal cortex (DLPFC) has been well-known to be effective in chronic pain management, in contrast to inhibition (cathodal tDCS) over somatosensory cortex (S1). Recent studies showed the effect of facilitation neuromodulation over S1 in reducing central pain sensitization.
Materials and Methods
A 24-year-old female presented with a 6-year history of refractory and chronic headaches after a motorcycle accident. The headaches worsened over the last 2 years after a traumatic psychological event. A completed 12-week course of tDCS was conducted for 20 minutes at 1 mA, 2 times/week, with a series of excitation and inhibition combinations on DLPFC, S1, and M1. Clinical evaluation was conducted at the end of each protocol by weeks 2, 8, and 12.
Results
Anodal tDCS over DLPFC, M1, and S1 led to decrease in VAS and frequency of acute attacks, a prolonged headache-free period, and an increase of work daily living. Cathodal tDCS over S1 seemed showed no response. The best result was found in the combination of anodal tDCS over left DLPFC with anodal tDCS over left S1.
Conclusions
tDCS neuromodulation on DLPFC, S1, and M1 seems effective in reducing central pain sensitization in chronic pain. Excitation produced by anodal tDCS on the somatosensory cortex is superior to the M1 or DLPFC for the alleviation of chronic headaches.
Central sensitization amplifies the neural signaling within the CNS and elicits pain hypersensitivity in chronic pain. It predicts poor treatment outcomes. Facilitation (anodal tDCS) of primary motor (M1) and/or dorsolateral prefrontal cortex (DLPFC) has been well-known to be effective in chronic pain management, in contrast to inhibition (cathodal tDCS) over somatosensory cortex (S1). Recent studies showed the effect of facilitation neuromodulation over S1 in reducing central pain sensitization.
Materials and Methods
A 24-year-old female presented with a 6-year history of refractory and chronic headaches after a motorcycle accident. The headaches worsened over the last 2 years after a traumatic psychological event. A completed 12-week course of tDCS was conducted for 20 minutes at 1 mA, 2 times/week, with a series of excitation and inhibition combinations on DLPFC, S1, and M1. Clinical evaluation was conducted at the end of each protocol by weeks 2, 8, and 12.
Results
Anodal tDCS over DLPFC, M1, and S1 led to decrease in VAS and frequency of acute attacks, a prolonged headache-free period, and an increase of work daily living. Cathodal tDCS over S1 seemed showed no response. The best result was found in the combination of anodal tDCS over left DLPFC with anodal tDCS over left S1.
Conclusions
tDCS neuromodulation on DLPFC, S1, and M1 seems effective in reducing central pain sensitization in chronic pain. Excitation produced by anodal tDCS on the somatosensory cortex is superior to the M1 or DLPFC for the alleviation of chronic headaches.
| Original language | English |
|---|---|
| Journal | Neuromodulation |
| Volume | 26 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 1 Apr 2023 |