Abstract
Several brain stimulation technologies are beginning to evidence promise as pain treatments.
However, traditional versions of 1 specific technique, transcranial direct current
stimulation (tDCS), stimulate broad regions of cortex with poor spatial precision.
A new tDCS design, called high definition tDCS (HD-tDCS), allows for focal delivery
of the charge to discrete regions of the cortex. We sought to preliminarily test the
safety and tolerability of the HD-tDCS technique as well as to evaluate whether HD-tDCS
over the motor cortex would decrease pain and sensory experience. Twenty-four healthy
adult volunteers underwent quantitative sensory testing before and after 20 minutes
of real (n = 13) or sham (n = 11) 2 mA HD-tDCS over the motor cortex. No adverse events
occurred and no side effects were reported. Real HD-tDCS was associated with significantly
decreased heat and cold sensory thresholds, decreased thermal wind-up pain, and a
marginal analgesic effect for cold pain thresholds. No significant effects were observed
for mechanical pain thresholds or heat pain thresholds. HD-tDCS appears well tolerated,
and produced changes in underlying cortex that are associated with changes in pain
perception. Future studies are warranted to investigate HD-tDCS in other applications,
and to examine further its potential to affect pain perception.
Perspective
This article presents preliminary tolerability and efficacy data for a new focal brain
stimulation technique called high definition transcranial direct current stimulation.
This technique may have applications in the management of pain.
Key words
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Article info
Publication history
Published online: November 21, 2011
Accepted:
July 12,
2011
Received in revised form:
April 18,
2011
Received:
December 13,
2010
Footnotes
Dr. Borckardt receives funding from the National Institutes Health (NINDS, NINR, NIDA), the South Carolina Translational Research Institute, The American Society for Gastrointestinal Endoscopy, and The Obesity Society (Covidien). The present study was funded by the National Institute for Neurological Disorders and Stroke (NINDS: 5K23NS050485-03). Dr. George reports research grants in the past 5 years from Glaxo-Smith Kline, Jazz Pharmaceuticals, Brainsway, Cephos, and Force Protection. He has been an unpaid advisor to Brainsonix, Brainsway, Neuronetics, Neostim and Neosync (as they make products related to TMS), and a paid advisor to Jazz, Cyberonics, Neuropace, and Puretech ventures. Dr. Bikson receives funding from NIH and the Wallace H Coulter Foundation. The full amount of Dr. Borckardt's advisory income has never been more than 10% of his university salary. MUSC has 2 patent applications in Dr. George's name on combining TMS with MRI imaging. CUNY has 5 patent applications in Dr. Bikson's and Dr. Datta's names. Dr. Bikson and Dr. Datta are co-founders of Soterix Medical.
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Copyright
© 2012 Published by Elsevier Inc.
