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.
Identification
Copyright
© 2012 Published by Elsevier Inc.
